Detection of Helicobacter pylori specific DNA in human atheromatous coronary arteries and its association to prior myocardial infarction and unstable angina.
BACKGROUND
Chronic infections have been proposed to play a role in the aetiology or progression of atherosclerotic plaques. Increased risk of coronary artery disease has been suggested in patients seropositive for Helicobacter pylori.


OBJECTIVE
To analyse coronary specimens in patients with severe (coronary artery disease) for Helicobacter pylori specific DNA.


METHODS
Atherosclerotic plaques were obtained in 46 consecutive patients (9 female, 37 male, mean age 62.7+/-9.17 years) during coronary bypass procedures. Serum was analysed for IgG -/cagA-antibodies specific for Helicobacter pylori. Polymerase chain reaction and sequence analysis were used to identify bacterial DNA. Coronary artery biopsies from 19 autopsies without coronary artery disease were examined as a control group.


RESULTS
Of the 46 coronary artery disease patients, 32 (69.6%) were Helicobacter pylori seropositive. Positive results for Helicobacter pylori DNA showed 18 seropositive and 4 seronegative (with anamnesis of eradication therapy). A total of 22 patients (47.8%) of the coronary artery disease group but none of controls revealed positive DNA. In the coronary artery disease group, a correlation between DNA presence and prior myocardial infarction (p=0.008) and unstable angina (p<0.001) was found.


CONCLUSIONS
Identification of DNA in atherosclerotic plaques of patients with severe coronary artery disease supports the hypothesis that Helicobacter pylori infection may influence the development of atherosclerosis. Our results may indicate an direct involvement of Helicobacter pylori in the progression and instability of plaques in these patients.
Department of Cardiology and Cardiac Surgery, Heart Center Osnabrück, Bad Rothenfelde, Germany.
M
M
Kowalski
W
W
Rees
P C
PC
Konturek
R
R
Grove
T
T
Scheffold
H
H
Meixner
M
M
Brunec
N
N
Franz
J W
JW
Konturek
P
P
Pieniazek
E G
EG
Hahn
S J
SJ
Konturek
J
J
Thale
H
H
Warnecke
D000368:Aged; D000789:Angina, Unstable / Q000382:microbiology; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000382:microbiology*; D004269:DNA, Bacterial / Q000032:analysis*; D005260:Female; D016481:Helicobacter Infections / Q000150:complications; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000382:microbiology; D016133:Polymerase Chain Reaction; D017422:Sequence Analysis, DNA
D004269:DNA, Bacterial