title: Lack of association of Helicobacter pylori infection with coronary artery disease and frequency of acute myocardial infarction or death.
abstract: We investigated the association between Helicobacter pylori (H. pylori) infection and coronary artery disease (CAD) in 2 study populations: (1) a cross-sectional study to determine risk of having CAD, and (2) a longitudinal study to determine risk of acute myocardial infarction (AMI) or death over a mean follow-up period of 3 years in patients with angiographically documented CAD. Blood samples were tested for serum immunoglobulin G antibodies to H. pylori and C-reactive protein (CRP) levels. Study 1: Of 391 patients (62% men, mean age 57 years), 41% had antibodies to H. pylori. CAD prevalence was 70% in H. pylori seropositive patients and 59% in seronegative patients (p = 0.03). Elevated CRP levels (>0.5 mg/dl) were significantly higher in patients with than without CAD (p = 0.02). By univariate analysis, CAD prevalence significantly increased stepwise depending on H. pylori seropositivity and elevated CRP levels (p = 0.008). Significance was lost after adjustment for traditional risk factors. Further analyses revealed that age was the critical confounder. Study 2: Of 929 patients (77% men, mean age 65 years), 56% had antibodies to H. pylori. By univariate analysis, the incidence of AMI or death was 22% in H. pylori seropositive patients and 18% in seronegative patients (p = 0.1). The adjusted hazard ratio of AMI or death for H. pylori seropositivity was 1.12 (95% confidence interval 0.81 to 1.54). Our data suggest that prior infection with H. pylori is not a major factor determining either risk of CAD, AMI, or death in patients with CAD.
authors.affiliation: Cardiovascular Research Institute of the MedStar Research Institute, Washington Hospital Center, Washington, DC 20010, USA.
authors.forename: Jianhui
authors.initials: J
authors.lastname: Zhu
authors.forename: Arshed A
authors.initials: AA
authors.lastname: Quyyumi
authors.forename: Joseph B
authors.initials: JB
authors.lastname: Muhlestein
authors.forename: F Javier
authors.initials: FJ
authors.lastname: Nieto
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Horne
authors.forename: Alexandra
authors.initials: A
authors.lastname: Zalles-Ganley
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Anderson
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Epstein
mesh_terms: D000367:Age Factors; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003327:Coronary Disease / Q000097:blood / Q000453:epidemiology / Q000276:immunology / Q000382:microbiology*; D003430:Cross-Sectional Studies; D005260:Female; D016481:Helicobacter Infections / Q000097:blood / Q000150:complications* / Q000453:epidemiology / Q000276:immunology; D016480:Helicobacter pylori; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000453:epidemiology / Q000276:immunology / Q000382:microbiology*; D015995:Prevalence; D012307:Risk Factors
chemical_list: D007074:Immunoglobulin G; D002097:C-Reactive Protein