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Helicobacter pylori infection is related to atheroma in patients undergoing coronary angiography
N Ossei-Gerning1, P Moayyedi, S Smith
1Unit of Molecular Vascular Medicine, Leeds General Infirmary, UK.
Insights
Helicobacter pylori infection is linked to coronary atheroma, a type of heart disease. This association does not appear to be caused by increased fibrinogen levels.
Area of Science:
- Cardiology
- Infectious Diseases
- Gastroenterology
Background:
- Helicobacter pylori infection is a potential risk factor for ischemic heart disease (IHD).
- The proposed mechanism involves elevated plasma fibrinogen, but evidence is conflicting.
- Previous studies have not differentiated between atheroma and thrombosis in this association.
Purpose of the Study:
- To investigate the association between H. pylori status and IHD.
- To assess the impact of H. pylori infection on coronary atheroma and thrombosis.
- To evaluate the influence of H. pylori on key hemostatic factors.
Main Methods:
- A cohort of Caucasian patients undergoing coronary angiography for suspected IHD was recruited.
- H. pylori status was determined via serology (Helico G).
- Coronary angiograms were analyzed for significant atheroma (>= 50% stenosis), and myocardial infarction history was recorded.
Main Results:
- H. pylori positivity was significantly higher in patients with IHD (68%) compared to those without (50%).
- H. pylori infection remained a significant independent predictor of IHD after logistic regression adjustment (OR=2.4).
- No significant relationship was found between H. pylori status and myocardial infarction history or levels of fibrinogen, PAI-1, vWF, or Factor VII.
Conclusions:
- H. pylori infection is associated with the presence of coronary atheroma.
- The link between H. pylori and coronary atheroma is unlikely to be mediated by elevated plasma fibrinogen.
- Further research may be needed to elucidate the precise mechanisms linking H. pylori to cardiovascular disease.
Objectives:
Helicobacter pylori infection has been related to an increased risk of ischaemic heart disease (IHD) possibly by raising plasma fibrinogen. The evidence for this association is conflicting. Furthermore, no attempt has been made to distinguish between an effect on atheroma and thrombosis. We have determined the association of H. pylori status with IHD assessed by coronary angiography. We have also evaluated the influence of H. pylori infection on haemostatic factors.
Methods:
Caucasian patients undergoing coronary angiography for suspected IHD were recruited. H. pylori status was determined by serology (Helico G). Plasma fibrinogen was measured by the Clauss assay. Coronary angiograms were assessed and significant atheroma defined as > or = 50% stenosis. A history of myocardial infarction was ascertained by WHO criteria.
Results:
292 patients were recruited (median age 59, 95 female); 204 (70%) patients had IHD and 185 (64%) of all patients were H. pylori-positive; 68% patients with IHD were H. pylori-positive compared with 50% without IHD (P = 0.003). When adjusted for other risk factors by logistic regression, H. pylori remained significantly associated with IHD (odds ratio = 2.4, 95% CI = 1.2-5.1, P = 0.02). H. pylori status was not related to a history of myocardial infarction. Circulating levels of PAI-1, vWF, Factor VII and fibrinogen were not related to H. pylori status.
Conclusion:
This study suggests that infection with H. pylori is associated with coronary atheroma, but that this relationship is unlikely to be mediated through raised plasma fibrinogen.