title: Association of Helicobacter pylori with coronary artery disease and myocardial infarction assessed by myocardial perfusion imaging.
abstract: BACKGROUND
  The relationship between Helicobacter pylori infection and coronary artery disease (CAD) has as yet not been fully examined. The myocardial perfusion imaging (MPI) stress test has proven its efficacy as an integral part of diagnosing CAD.
  
  
  OBJECTIVE
  To investigate the association between CAD and H. pylori infection using MPI.
  
  
  METHODS
  This prospective study evaluated CAD positivity among consecutive patients referred to a tertiary medical center for a stress/rest MPI. All patients were tested for serum anti-H. pylori and CagA protein immunoglobulin G antibodies. The CAD positivity group included patients with ischemia and/or myocardial infarction (MA) on a stress MPI, coronary artery bypass graft surgery (CABG), or percutaneous coronary interventions (PCI). CAD-negative subjects were defined as participants with a normal MPI, no pathological Q waves in resting ECG tracing, and no history of CAD. Both groups were compared for H. pylori and CagA seropositivity. Patients' demographic data, risk factors for CAD, and childhood socioeconomic status were recorded.
  
  
  RESULTS
  The study group consisted of 300 consecutive patients, 170 men and 130 women; 64% (110/173) CAD-positive patients and 47% (60/127) CAD-negative participants were found seropositive for H. pylori infection (P = 0.005). In the adjusted analysis, H. pylori infection was found to be associated with CAD positivity (odds ratio 1.83, 95% confidence interval 1.06-3.17, P = 0.031), and MI (fixed perfusion defects on MPI) (OR 3.36, 95% CI 1.44-7.84, P = 0.005). No association was noted with CagA positivity.
  
  
  CONCLUSIONS
  In patients undergoing a stress MPI, serum anti-H. pylori antibodies positivity was found to be associated with CAD, independent of traditional cardiovascular risk factors.
authors: Haim
authors: H
authors: Shmuely
authors: Morad
authors: M
authors: Wattad
authors: Alejandro
authors: A
authors: Solodky
authors: Jacob
authors: J
authors: Yahav
authors: Zmira
authors: Z
authors: Samra
authors: Nili
authors: N
authors: Zafrir
mesh_terms: D000368:Aged; D000942:Antigens, Bacterial / Q000276:immunology; D001426:Bacterial Proteins / Q000276:immunology; D001026:Coronary Artery Bypass / Q000379:methods; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000382:microbiology* / Q000503:physiopathology; D004562:Electrocardiography; D005080:Exercise Test / Q000379:methods; D005260:Female; D016481:Helicobacter Infections / Q000503:physiopathology*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000382:microbiology*; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D062645:Percutaneous Coronary Intervention / Q000379:methods; D011446:Prospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D062606:Tertiary Care Centers
chemical_list: D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D007074:Immunoglobulin G; C080866:cagA protein, Helicobacter pylori