Moving beyond unfractionated heparin for acute coronary syndromes: Xeno's Paradox revisited.

only by a few. However, new tests have been developed for the diagnosis of acute infections and their applicability to chronic infections is an open question. It has been suggested that IgA and precipitated or trapped immunocomplexes possess a better predictive value than IgG antibodies. Other than IgA, Tavendale et al. also measured immune complexes in sera with the conglutinin method. Both tests were unable to predict events in years to come. So far, we have not found a specific serological marker which would predict the future activity of C. pneumoniae found in plaques. We know that it is very often ‘sitting there’ but what it is doing remains a question. A commercial, reproducible test using PCR from, e.g., circulating white blood cells, is lacking and in-house tests are variable in their results. In the future it is to be hoped that we will find diagnostic markers circulating in the blood which will indicate the amount of C. pneumoniae activity in the body and, perhaps in future intervention studies, how well we have succeeded in eradicating the agent from vascular lesions. So far we only have non-specific markers of inflammation or autoimmunity, which, in combination with C. pneumoniae markers, may be better predictors of future outcome. P. SAIKKU Department of Medical Microbiology, University of Oulu, Oulu, Finland