Background: Atherosclerosis, inflammation and coronary plaque destabilization are
linked to each other. Infections due to various microbes may trigger Acute Coronary Syndrome
(ACS) by systemic inflammation cascade.
Methods: We have evaluated the prevalence of Post Chikungunya Chronic Arthritis (PCCA)
among 400 consecutive ACS patients (Case group) and compared with control group subjected to
elective surgery by the prospective case-control observational study. Cases were excluded if standard
criteria of ACS were not satisfied and in the control group if the patient suffered a Myocardial
Infarction (MI) within 28 days of elective surgery. PCCA duration more than two years or serum
IgM anti-CCP positive patients were also excluded from the case as well as a control group.
Results: The case and control groups were similar except, less number of heart failure (O.R.7.3,
95% C.I. 3.3-15.9) and chronic kidney injury patients (O.R. 0.5, 95% C.I. 0.3-0.9) in the elective
surgery (control) group. PCCA was present in 24 out of 400 ACS cases and 8 out of 400 control
group. Among ACS case-patients, those suffering from PCCA tended to be younger and more often
women, with more diabetes, hypertension, chronic kidney injury and high mean CRP. In unadjusted
analysis PCCA was three times more common in the case versus control (O.R. 3.0, 95% C.I. 1.4-
6.4); results were indistinguishable after multidiscipline adjustment (O.R. 3.0, 95% C.I. 1.3-6.8).
Conclusion: PCCA is common among patients with ACS and post-infective systemic inflammation
of PCCA may trigger plaque destabilization.