Seroprevalence of Toxoplasmosis and the Possible Role of C-Reactive Protein in the Pathogenesis of Myocardial Infarction in Patients from Iraq; A Case Control Study.

Abstract

Background: The objective of this study was to assess the seroepidemiological prevalence of Toxoplasma gondii infection, as well as the serum concentrations and expression levels of C-reactive protein (CRP) in patients diagnosed with myocardial infarction (MI) in Iraq.

Methods: This case-control study involved 200 patients diagnosed with myocardial infarction (MI) and a control group of 200 healthy individuals (non-MI) in Baghdad, Iraq, conducted from September 2023 to October 2024. Anti-Toxoplasma IgG and IgM levels, along with serum concentrations of C-reactive protein (CRP), were evaluated using an enzyme-linked immunosorbent assay (ELISA) kit. Additionally, the expression level of CRP was measured through real-time polymerase chain reaction (PCR).

Results: The prevalence of anti-Toxoplasma IgG antibodies was found in 111 individuals (55.5%) within the MI group, compared to 92 individuals (42.9%) in the non-MI group. Serum levels and expression of the CRP gene were significantly elevated (P < 0.001) in MI patients who were seropositive for T. gondii antibodies, in comparison to both seronegative MI patients and non-MI participants. The results of the multivariate analysis indicated that individuals aged 30 to 40 years had a 2.14 times higher likelihood of being infected with T. gondii compared to other age groups (p = 0.032, CI = 1.121-4.21). Additionally, MI patients who consumed raw or undercooked meat exhibited 2.26 times greater likelihood of T. gondii infection compared to those who did not consume such meat (p = 0.003, OR = 2.26, CI = 1.372-4.861). Furthermore, female participants diagnosed with MI showed a 3.21-fold increased probability of contracting Toxoplasma infection (p = 0.002, CI = 1.521-7.321).

Conclusion: We found a high prevalence of anti-T. gondii antibodies in patients with MI compared to those without MI. These findings suggest a potential role of CRP in the pathogenesis of MI. Furthermore, elevated levels of CRP may provide a valuable framework for further investigation into the role of T. gondii in the context of MI. However, additional studies are needed to confirm these findings by evaluating some key biomarkers, as high-sensitivity (Hs-CRP).