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Flow mediated dilatation of the brachial artery is lower in diabetic children with HLA DQ 2/8 genotype and CRP>1 than in those with CRP<1.Carotid intima-media thickness progression is faster in children with HLA DQ 2/8 genotype experiencing three or more respiratory tract infections/year within 18 months follow-up period than in those experiencing fewer infections.Patients with acute coronary syndromes (ACS) have preceding flu like symptoms like tiredness not associated with physical exercise.Enterovirus titres, herpes virus titres and Chlamydia pneumonia antibody concentrations are elevated in patients with ACS suggesting that an ongoing inflammation is associated with cardiovascular events.Chronic infections like those initiated by periodontitis associate with stenosing lesions in the coronary arteries.These findings suit well with the response of injury theory.Coronary disease is silent in children, obstructing lesions develop by a chronic inflammatory stimulus but clinical coronary events may arise by the effect of acute infections.