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[Ischemic cardiovascular diseases. Correlation with Helicobacter pylori infection]
R Pellicano1, E Oliaro, L Mangiardi
1UOADU Gastro-Epatologia Azienda Ospedaliera San Giovanni Battista (Molinette), Torino. rinaldo-pellicano@hotmail.com
Insights
Helicobacter pylori (H. pylori) infection may be weakly associated with coronary heart disease. Further prospective studies are needed to confirm if H. pylori causes myocardial infarction or stroke.
Area of Science:
- Cardiology
- Infectious Diseases
- Gastroenterology
Background:
- Coronary heart disease (CHD) is a leading cause of death, with traditional risk factors insufficient to explain all variations.
- Infections are increasingly linked to ischemic vascular events, with Helicobacter pylori (H. pylori) emerging as a potential factor.
- H. pylori, a common stomach bacterium, is known for gastritis and peptic ulcers, but its role in cardiovascular disease is under investigation.
Purpose of the Study:
- To explore the potential association between Helicobacter pylori infection and coronary heart disease.
- To investigate the role of H. pylori in the pathogenesis of ischemic vascular events, particularly acute myocardial infarction.
Main Methods:
- Systematic reviews suggest a weak positive association between H. pylori and CHD, though confounding and heterogeneity exist.
- Animal studies show H. pylori infection promotes platelet aggregation.
- Absence of H. pylori in atherosclerotic plaques suggests a potential role in acute phases of cardiovascular events.
Main Results:
- Existing systematic reviews indicate a possible, albeit weak, positive association between H. pylori and CHD.
- Animal models demonstrate H. pylori's ability to induce platelet aggregation.
- H. pylori has not been detected within atherosclerotic plaques, unlike Chlamydia pneumoniae.
Conclusions:
- The association between H. pylori and coronary heart disease requires further investigation due to potential confounding factors and study heterogeneity.
- Prospective studies are essential to determine the incidence of cardiovascular events in relation to H. pylori infection.
- Randomized controlled trials using antibiotic treatment for ischemic vascular disease patients are needed to establish a causal link between H. pylori and acute myocardial infarction or stroke.
Abstract:
Coronary heart disease is the primary cause of mortality in western countries. The well-established ("classical") risk factors cannot fully explain epidemiological variations of this disease. From several years infections have been linked to ischemic vascular events and recent studies pointed to the role of Helicobacter pylori (H. pylori), a spiral Gram negative bacterium, that chronically infects human stomach and is involved in the pathogenesis of gastritis and peptic ulceration. Systematic reviews of studies have suggested the existence of a possible weakly positive association between this bacterium and coronary heart disease, but this could be due to confounding bias and influenced by the degree of investigations heterogeneity. Experiments from animal studies demonstrated that H. pylori infection in mice induces the formation of platelet aggregates and in contrast to Chlamydia pneumoniae it has not been found in the plaque: therefore, the role of H. pylori, could be even more important in the acute phase of myocardial infarction. There is the need for extensive prospective studies to evaluate the incidence of these diseases in relation to the presence of H. pylori infection. Appropriately randomized studies employing an antibiotic treatment for patients affected by ischemic vascular disease will answer the question of whether H. pylori has a causal role in the pathogenesis of acute myocardial infarction and ischemic stroke.