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Helicobacter pylori infection and early onset myocardial infarction: case-control and sibling pairs study

J Danesh1, L Youngman, S Clark

  • 1Clinical Trial Service Unit, Nuffield Department of Clinical Medicine, University of Oxford, Radcliffe Infirmary, Oxford OX2 6HE. john.danesh@balliol.ox.ac.uk

BMJ (Clinical Research Ed.)
|December 14, 1999
PubMed

Insights

Chronic Helicobacter pylori infection shows a moderate association with coronary heart disease. Further large trials are needed to confirm causality and the effects of H. pylori eradication.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Epidemiology

Background:

  • Coronary heart disease (CHD) is a leading cause of mortality worldwide.
  • The role of chronic infections, such as Helicobacter pylori (H. pylori), as a potential risk factor for CHD is under investigation.

Purpose of the Study:

  • To investigate the association between chronic Helicobacter pylori infection and the risk of developing coronary heart disease, specifically early-onset myocardial infarction.

Main Methods:

  • A case-control study involving 1122 survivors of myocardial infarction (ages 30-49) and 1122 matched controls.
  • A sibling-pair study of 510 pairs where one sibling had myocardial infarction and the other did not.
  • Serological testing was used to detect chronic H. pylori infection.

Main Results:

  • Individuals with early-onset myocardial infarction had a significantly higher prevalence of H. pylori antibodies (42%) compared to controls (24%), with an initial odds ratio of 2.28.
  • The association remained significant after adjusting for smoking, socioeconomic status, lipids, and obesity, with an adjusted odds ratio of 1.75.
  • The sibling-pair analysis showed a weaker, non-significant association (odds ratio 1.33).

Conclusions:

  • These studies suggest a moderate association between coronary heart disease and H. pylori seropositivity, independent of common risk factors.
  • While the association may be causal, large randomized trials are necessary to confirm this and assess the impact of H. pylori eradication.
Abstract

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