title: Association of virulent Helicobacter pylori strains with ischemic heart disease.
abstract: BACKGROUND
  Previous studies have reported an association between chronic Helicobacter pylori infection and ischemic heart disease. However, it is not clear whether this association is really due to the virulence of the bacterium or is merely the result of confounding factors (in particular, age and social class).
  
  
  RESULTS
  We assessed the prevalence of infection by Helicobacter pylori and by strains bearing the cytotoxin-associated gene-A (CagA), a strong virulence factor, in 88 patients with ischemic heart disease (age, 57+/-8 years; 74 men) and in 88 age- and sex-matched controls (age, 57+/-8 years; 74 men) with similar social background. Prevalence of Helicobacter infection was significantly higher in patients than in controls (62% versus 40%; P=.004), with an odds ratio of 2.8 (95% CI, 1.3 to 7.4; P<.001) adjusted for age, sex, main cardiovascular risk factors, and social class. Patients with ischemic heart disease also had a higher prevalence of CagA-positive strains (43% versus 17%; P=.0002), with an adjusted odds ratio of 3.8 (95% CI, 1.6 to 9.1; P<.001). Conversely, prevalence of CagA-negative strains was similar in patients and controls (19% versus 23%), with an adjusted odds ratio of 0.8 (95% CI, 0.4 to 1.4).
  
  
  CONCLUSIONS
  The association between Helicobacter pylori and ischemic heart disease seems to be due to a higher prevalence of more virulent Helicobacter strains in patients. These results support the hypothesis that Helicobacter pylori may influence atherogenesis through low-grade, persistent inflammatory stimulation.
authors.affiliation: Department of Internal Medicine, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Pasceri
authors.forename: G
authors.initials: G
authors.lastname: Cammarota
authors.forename: G
authors.initials: G
authors.lastname: Patti
authors.forename: L
authors.initials: L
authors.lastname: Cuoco
authors.forename: A
authors.initials: A
authors.lastname: Gasbarrini
authors.forename: R L
authors.initials: RL
authors.lastname: Grillo
authors.forename: G
authors.initials: G
authors.lastname: Fedeli
authors.forename: G
authors.initials: G
authors.lastname: Gasbarrini
authors.forename: A
authors.initials: A
authors.lastname: Maseri
mesh_terms: D000368:Aged; D000942:Antigens, Bacterial; D001426:Bacterial Proteins / Q000032:analysis; D005260:Female; D016481:Helicobacter Infections / Q000150:complications*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000209:etiology*
chemical_list: D000942:Antigens, Bacterial; D001426:Bacterial Proteins; C080866:cagA protein, Helicobacter pylori