Are anti-Chlamydia pneumoniae antibodies prognosis indicators for peripartum cardiomyopathy?

Background The authors recently pointed out an epidemiological relation between specific anti-Chlamydia pneumoniae antibodies and peripartum cardiomyopathy in Niamey (Republic of Niger). Design In this work, they studied the prognosis value of such specific antibodies. Methods The serological status for specific IgG, IgA and IgM anti-C. pneumoniae antibodies of 50 African women (age, mean +/- SD = 30.2 +/- 7 years) hospitalized in Niamey, with peripartum cardiomyopathy, was determined at the time of diagnosis. The diagnosis was categorized as 'complete remission' (113 patients, age = 29.3 +/- 6.5 years, observation delay = 27 months), 'incomplete remission'(27 patients, age = 30.7 +/- 6 years, observation delay = 14 months) and 'deceased' (110 patients, age = 30.3 +/- 6.2 years, observation delay = 13 months). The control group comprised 27 African women (age = 25.2 +/- 4.6 years), living in the same area. The Mann-Whitney and Fisher's exact tests were used for the statistical comparison. Results The dilution of IgG specific anti-C. pneumoniae antibodies was higher (P = 0.047) in the 'incomplete remission' compared with 'complete remission'. The dilution of IgA specific anti-C. pneumoniae antibodies was higher (P = 0.033) in the patients with a severe evolution ('deceased' + 'incomplete remission) compared with 'complete remission. There was no significant difference between patients in 'complete remission' compared with 'controls'. Conclusions At the time of peripartum cardiomyopathy diagnosis the specific IgG and IgA anti-C. pneumoniae antibodies are of prognosis value: a high dilution is more often associated with a poor prognosis. This is the first identified prognosis factor during the precocious evolution of peripartum cardiomyopathy. J Cardiovasc Risk 10:195-199 (C) 2003 Lippincott Williams Wilkins.