Response to Letters Regarding Article, “Bacterial Signatures in Thrombus Aspirates of Patients With Myocardial Infarction”

Abstract

We thank the authors of the letters for their interest in our publication.1 Their comments focused on Chlamydia pneumoniae –negative finding, role of infection burden and coexistence of multiple pathogens, clinical usefulness of findings, and how the chronic oral infection is involved in acute coronary events. For the last 2 decades, C pneumoniae has been the strongest candidate bacteria behind atherosclerotic inflammation. According to the recent review by Joshi et al,2 there are a total of 1652 published articles on this subject, and various techniques (immunocytochemistry, polymerase chain reaction [PCR], in situ hybridization, electron microscopy, and culturing) have been used to determine the presence of C pneumoniae in vascular tissues. The range of C pneumoniae –positive patients varies greatly across studies from 0% to 100%. Apfalter et al3 reported that 89% of all patients studied had C pneumoniae –specific antibodies, but the pathogen was not detected in a single carotid atheroma by real-time PCR and cell culture in carotid endarterectomy samples. So …