Research Article
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Association of helicobacter pylori infection with coronary artery disease and the severity of angiographic lesions

Year 2025, Volume: 2 Issue: 1, 38 - 48, 15.02.2025
https://doi.org/10.70058/cjm.1555530

Abstract

Objective: There are controversies evaluating the association between different strains of Helicobacter pylori (HP) and occurrence of coronary arterial disease (CAD). HP may facilitate gastric ulcers and gastrointestinal bleeding. As angiographic lesions of high thrombus burden needs more potent and risky antithrombotic treatment regimens, we aimed to investigate the role of different strains of HP for angiographic lesions with high thrombus burden.
Methods: Medical and drug history of 109 consecutive patients who were candidate for coronary angiography were taken. Blood samples were obtained to measure anti HP (Ig) immunoglobulin G and anti-CagA (cytotoxin-associated gene) IgG antibody. According to angiography reports, participants were divided into three groups. Normal (n = 34), lesions with no thrombus (n=38) and lesions with thrombus (n = 37). To measure the association between CagA positive and less virulan strains of HP with the severity of CAD, ordinal logistic regression tests were used by adjusting age, sex, history of hypertention, diabetes mellitus , dyslipidemia and smoking.
Results: The mean ages of patients with and without CAD were 59±14. The prevalence of seropositivity to HP IgG titer was 69% (n=75). Fifty nine (79%) subject had CagA IgG seropositivity. Positive CagA IgG serology was 67% (n=50) and 44% (n=15) in CAD and control groups respectively. While HP IgG serology wasn’t associated with lesion severity; CagA IgG serology was independently associated with lesion severity (OR: 2.4 (1.1-5.6) p=0.03).
Conclusion: Colonization of CagA positive HP was an independent risk factor for angiographic lesion severity..

Ethical Statement

. Bütün hastaların aydınlatılmış onamı alındı. Bu çalışma Ankara Eğitim ve Araştırma Hastanesi Eğitim Planlama ve Koordinasyon Kurulu tarafından 13-3-2013 tarihinde 4123 numaralı karar ile onaylandıktan sonra yapıldı.

Thanks

Tez danışmanım Dr selman ünverdiye tezimin hazırlanmasında göstermiş olduğu katkılarından dolayı teşekkür ederim

References

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  • Zhou G, Lin Z, Miao Q, et al. Mechanisms of QingRe HuoXue Formula in atherosclerosis Treatment: An integrated approach using Bioinformatics, Machine Learning, and experimental validation. Int Immunopharmacol. 2024;141:112890. doi:10.1016/j.intimp.2024.112890
  • Ridker PM. Inflammation, infection, and cardiovascular risk: how good is the clinical evidence?. Circulation. 1998;97(17):1671-1674. doi:10.1161/01.cir.97.17.1671
  • Danesh J, Collins R, Peto R. Chronic infections and coronary heart disease: is there a link?. Lancet. 1997;350(9075):430-436. doi:10.1016/S0140-6736(97)03079-1
  • Ross R. Atherosclerosis--an inflammatory disease. N Engl J Med. 1999;340(2):115-126. doi:10.1056/NEJM199901143400207
  • Epstein SE, Zhu J, Burnett MS, Zhou YF, Vercellotti G, Hajjar D. Infection and atherosclerosis: potential roles of pathogen burden and molecular mimicry. Arterioscler Thromb Vasc Biol. 2000;20(6):1417-1420. doi:10.1161/01.atv.20.6.1417
  • Wang F, Yao Z, Jin T, Mao B, Shao S, Shao C. Research progress on Helicobacter pylori infection related neurological diseases. Ageing Res Rev. 2024;99:102399. doi:10.1016/j. arr.2024.102399
  • Huard K, Haddad K, Saada Y, et al. Prevalence of H. pylori among patients undergoing coronary angiography (The HPDAPT prevalence study). Sci Rep. 2022;12(1):16591. Published 2022 Oct 5. doi:10.1038/s41598-022- 7034-0
  • Morgando A, Sanseverino P, Perotto C, Molino F, Gai V, Ponzetto A. Helicobacter pylori seropositivity in myocardial infarction. Lancet. 1995;345(8961):1380.
  • Martîn-de-Argila C, Boixeda D, Cantón R, Gisbert JP, Fuertes A. High seroprevalence of Helicobacter pylori infection in coronary heart disease. Lancet. 1995;346(8970):310. doi:10.1016/s0140-6736(95)92195-8
  • Zhu J, Quyyumi AA, Muhlestein JB, et al. Lack of association of Helicobacter pylori infection with coronary artery disease and frequency of acute myocardial infarction or death. Am J Cardiol. 2002;89(2):155-158. doi:10.1016/s0002-9149(01)02192-0
  • Murray LJ, Bamford KB, Kee F, et al. Infection with virulent strains of Helicobacter pylori is not associated with ischaemic heart disease: evidence from a population-based case-control study of myocardial infarction.Atherosclerosis. 2000;149(2):379-385. doi:10.1016/s0021-9150(99)00325-1
  • Pasceri V, Patti G, Cammarota G, Pristipino C, Richichi G, Di Sciascio G. Virulent strains of Helicobacter pylori and vascular diseases: a meta-analysis. Am Heart J. 2006;151(6):1215-1222. doi:10.1016/j.ahj.2005.06.041
  • Tanigawa T, Watanabe T, Nadatani Y, et al. Gastrointestinal bleeding after percutaneous coronary intervention. Digestion. 2011;83(3):153-160. doi:10.1159/000321813
  • Anderson HVS, Masri SC, Abdallah MS, et al. 2022 ACC/AHA Key Data Elements and Definitions for Chest Pain and Acute Myocardial Infarction: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Data Standards. Circ Cardiovasc Qual Outcomes. 2022;15(10):e000112. doi:10.1161/HCQ.0000000000000112
  • Matsukura N, Onda M, Tokunaga A, Kato S, Yamashita K, Ohbayashi M. Detection of Helicobacter pylori DNA in gastric juice by the polymerase chain reaction: comparison with findings in bacterial culture and the detection of tissue IgA and serum IgG antibodies against Helicobacter pylori. J Gastroenterol. 1995;30(6):689-695. doi:10.1007/BF02349633
  • Ozaydin N, Turkyilmaz SA, Cali S. Prevalence and risk factors of Helicobacter pylori in Turkey: a nationally-representative, cross-sectional, screening with the ¹³C-Urea breath test. BMC Public Health. 2013;13:1215. Published 2013 Dec 21. doi:10.1186/1471-2458-13-1215
  • Jafarzadeh A, Nemati M, Tahmasbi M, Ahmadi P, Rezayati MT, Sayadi AR. The association between infection burden in Iranian patients with acute myocardial infarction and unstable angina. Acta Med Indones. 2011;43(2):105-111.
  • Rogha M, Dadkhah D, Pourmoghaddas Z, Shirneshan K, Nikvarz M, Pourmoghaddas M. Association of helicobacter pylori infection with severity of coronary heart disease. ARYA Atheroscler. 2012;7(4):138-141.
  • Rogha M, Nikvarz M, Pourmoghaddas Z, Shirneshan K, Dadkhah D, Pourmoghaddas M. Is helicobacter pylori infection a risk factor for coronary heart disease?. ARYA Atheroscler. 2012;8(1):5-8.
  • Kowalski M, Konturek PC, Pieniazek P, et al. Prevalence of Helicobacter pylori infection in coronary artery disease and effect of its eradication on coronary lumen reduction after percutaneous coronary angioplasty. Dig Liver Dis. 2001;33(3):222-229. doi:10.1016/s1590-8658(01)80711-8
  • Sandifer QD, Vuilo S, Crompton G. Association of Helicobacter pylori infection with coronary heart disease. Association may not be causal. BMJ. 1996;312(7025):251. doi:10.1136/bmj.312.7025.251a
  • Danesh J, Peto R. Risk factors for coronary heart disease and infection with Helicobacter pylori: meta-analysis of 18 studies. BMJ. 1998;316(7138):1130-1132. doi:10.1136/bmj.316.7138.1130
  • Zhang S, Guo Y, Ma Y, Teng Y. Cytotoxin-associated geneA-seropositive virulent strains of Helicobacter pylori and atherosclerotic diseases: a systematic review. Chin Med J (Engl). 2008;121(10):946-951.
  • Niccoli G, Franceschi F, Cosentino N, et al. Coronary atherosclerotic burden in patients with infection by CagApositive strains of Helicobacter pylori. Coron Artery Dis. 2010;21(4):217-221. doi:10.1097/MCA.0b013e3283399f36
  • Franceschi F, Niccoli G, Ferrante G, et al. CagA antigen of Helicobacter pylori and coronary instability: insight from a clinico-pathological study and a meta-analysis of 4241 cases. Atherosclerosis. 2009;202(2):535-542. doi:10.1016/j.atherosclerosis.2008.04.051
  • Ikeda A, Iso H, Sasazuki S, Inoue M, Tsugane S; JPHC Study Group. The combination of Helicobacter pylori-and cytotoxinassociated gene-A seropositivity in relation to the risk of myocardial infarction in middle-aged Japanese: The Japan Public Health Center-based study. Atherosclerosis. 2013;230(1):67-72. doi:10.1016/j.atherosclerosis.2013.06.013
  • Eskandarian R, Ghorbani R, Shiyasi M, Momeni B, Hajifathalian K, Madani M. Prognostic role of Helicobacter pylori infection in acute coronary syndrome: a prospective cohort study. Cardiovasc J Afr. 2012;23(3):131-135. doi:10.5830/CVJA-2011-016
  • Elizalde JI, Pérez-Pujol S, Heras M, et al. Effects of Helicobacter pylori eradication on platelet activation and disease recurrence in patients with acute coronary syndromes. Helicobacter. 2004;9(6):681-689. doi:10.1111/j.1083-4389.2004.00271.x
  • Malfertheiner P, Mégraud F, O’Morain C, et al. Current European concepts in the management of Helicobacter pylori infection the Maastricht Consensus Report. The European Helicobacter Pylori Study Group (EHPSG). Eur J Gastroenterol Hepatol. 1997;9(1):1-2. doi:10.1097/00042737-199701000-00002
  • Singla S, Sachdeva R, Uretsky BF. The risk of adverse cardiac and bleeding events following noncardiac surgery relative to antiplatelet therapy in patients with prior percutaneous coronary intervention. J Am Coll Cardiol. 2012;60(20):2005-2016. doi:10.1016/j.jacc.2012.04.062
  • Abraham NS, Hlatky MA, Antman EM, et al. ACCF/ACG/AHA 2010 expert consensus document on the concomitant use of proton pump inhibitors and thienopyridines: a focused update of the ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use. A Report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents. J Am Coll Cardiol. 2010;56(24):2051-2066. doi:10.1016/j.jacc.2010.09.010
  • Vilariño-Rico J, Fariña-Casanova X, Martínez-Gallego EL, et al. The Influence of the Socioeconomic Status and the Density of the Population on the Outcome After Peripheral Artery Disease. Ann Vasc Surg. 2023;89:269-279. doi:10.1016/j.avsg.2022.09.049
  • Ridker PM, Danesh J, Youngman L, et al. A prospective study of Helicobacter pylori seropositivity and the risk for future myocardial infarction among socioeconomically similar U.S. men. Ann Intern Med. 2001;135(3):184-188. doi:10.7326/0003-4819-135-3-200108070-00010
  • Marietti M, Gasbarrini A, Saracco G, Pellicano R. Helicobacter pylori infection and diabetes mellitus: the 2013 state of art. Panminerva Med. 2013;55(3):277-281.
  • Wang F, Liu J, Lv Z. Association of Helicobacter pylori infection with diabetes mellitus and diabetic nephropathy: a meta-analysis of 39 studies involving more than 20,000 participants. Scand J Infect Dis. 2013;45(12):930-938. doi:10.3109/00365548.2013.844351
  • Whincup PH, Mendall MA, Perry IJ, Strachan DP, Walker M. Prospective relations between Helicobacter pylori infection, coronary heart disease, and stroke in middle aged men. Heart. 1996;75(6):568-572. doi:10.1136/hrt.75.6.568
  • Brown LM. Helicobacter pylori: epidemiology and routes of transmission. Epidemiol Rev. 2000;22(2):283-297. doi:10.1093/oxfordjournals.epirev.a018040
  • Min BJ, Seo ME, Bae JH, Kim JW, Kim JH. Development and validation of next-generation sequencing panel for personalized Helicobacter pylori eradication treatment targeting multiple species [published correction appears in Front Cell Infect Microbiol. 2024 Oct 25;14:1502072. doi: 10.3389/fcimb.2024.1502072]. Front Cell Infect Microbiol. 2024;14:1379790. Published 2024 Aug 29. doi:10.3389/fcimb.2024.1379790

Helicobacter pylori enfeksiyonunun koroner arter hastalığı ve anjiyografik lezyonların şiddeti ile ilişkisi

Year 2025, Volume: 2 Issue: 1, 38 - 48, 15.02.2025
https://doi.org/10.70058/cjm.1555530

Abstract

References

  • Ott SJ, El Mokhtari NE, Musfeldt M, et al. Detection of diverse bacterial signatures in atherosclerotic lesions of patients with coronary heart disease. Circulation. 2006;113(7):929-937. doi:10.1161/CIRCULATIONAHA.105.579979
  • Zhou G, Lin Z, Miao Q, et al. Mechanisms of QingRe HuoXue Formula in atherosclerosis Treatment: An integrated approach using Bioinformatics, Machine Learning, and experimental validation. Int Immunopharmacol. 2024;141:112890. doi:10.1016/j.intimp.2024.112890
  • Ridker PM. Inflammation, infection, and cardiovascular risk: how good is the clinical evidence?. Circulation. 1998;97(17):1671-1674. doi:10.1161/01.cir.97.17.1671
  • Danesh J, Collins R, Peto R. Chronic infections and coronary heart disease: is there a link?. Lancet. 1997;350(9075):430-436. doi:10.1016/S0140-6736(97)03079-1
  • Ross R. Atherosclerosis--an inflammatory disease. N Engl J Med. 1999;340(2):115-126. doi:10.1056/NEJM199901143400207
  • Epstein SE, Zhu J, Burnett MS, Zhou YF, Vercellotti G, Hajjar D. Infection and atherosclerosis: potential roles of pathogen burden and molecular mimicry. Arterioscler Thromb Vasc Biol. 2000;20(6):1417-1420. doi:10.1161/01.atv.20.6.1417
  • Wang F, Yao Z, Jin T, Mao B, Shao S, Shao C. Research progress on Helicobacter pylori infection related neurological diseases. Ageing Res Rev. 2024;99:102399. doi:10.1016/j. arr.2024.102399
  • Huard K, Haddad K, Saada Y, et al. Prevalence of H. pylori among patients undergoing coronary angiography (The HPDAPT prevalence study). Sci Rep. 2022;12(1):16591. Published 2022 Oct 5. doi:10.1038/s41598-022- 7034-0
  • Morgando A, Sanseverino P, Perotto C, Molino F, Gai V, Ponzetto A. Helicobacter pylori seropositivity in myocardial infarction. Lancet. 1995;345(8961):1380.
  • Martîn-de-Argila C, Boixeda D, Cantón R, Gisbert JP, Fuertes A. High seroprevalence of Helicobacter pylori infection in coronary heart disease. Lancet. 1995;346(8970):310. doi:10.1016/s0140-6736(95)92195-8
  • Zhu J, Quyyumi AA, Muhlestein JB, et al. Lack of association of Helicobacter pylori infection with coronary artery disease and frequency of acute myocardial infarction or death. Am J Cardiol. 2002;89(2):155-158. doi:10.1016/s0002-9149(01)02192-0
  • Murray LJ, Bamford KB, Kee F, et al. Infection with virulent strains of Helicobacter pylori is not associated with ischaemic heart disease: evidence from a population-based case-control study of myocardial infarction.Atherosclerosis. 2000;149(2):379-385. doi:10.1016/s0021-9150(99)00325-1
  • Pasceri V, Patti G, Cammarota G, Pristipino C, Richichi G, Di Sciascio G. Virulent strains of Helicobacter pylori and vascular diseases: a meta-analysis. Am Heart J. 2006;151(6):1215-1222. doi:10.1016/j.ahj.2005.06.041
  • Tanigawa T, Watanabe T, Nadatani Y, et al. Gastrointestinal bleeding after percutaneous coronary intervention. Digestion. 2011;83(3):153-160. doi:10.1159/000321813
  • Anderson HVS, Masri SC, Abdallah MS, et al. 2022 ACC/AHA Key Data Elements and Definitions for Chest Pain and Acute Myocardial Infarction: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Data Standards. Circ Cardiovasc Qual Outcomes. 2022;15(10):e000112. doi:10.1161/HCQ.0000000000000112
  • Matsukura N, Onda M, Tokunaga A, Kato S, Yamashita K, Ohbayashi M. Detection of Helicobacter pylori DNA in gastric juice by the polymerase chain reaction: comparison with findings in bacterial culture and the detection of tissue IgA and serum IgG antibodies against Helicobacter pylori. J Gastroenterol. 1995;30(6):689-695. doi:10.1007/BF02349633
  • Ozaydin N, Turkyilmaz SA, Cali S. Prevalence and risk factors of Helicobacter pylori in Turkey: a nationally-representative, cross-sectional, screening with the ¹³C-Urea breath test. BMC Public Health. 2013;13:1215. Published 2013 Dec 21. doi:10.1186/1471-2458-13-1215
  • Jafarzadeh A, Nemati M, Tahmasbi M, Ahmadi P, Rezayati MT, Sayadi AR. The association between infection burden in Iranian patients with acute myocardial infarction and unstable angina. Acta Med Indones. 2011;43(2):105-111.
  • Rogha M, Dadkhah D, Pourmoghaddas Z, Shirneshan K, Nikvarz M, Pourmoghaddas M. Association of helicobacter pylori infection with severity of coronary heart disease. ARYA Atheroscler. 2012;7(4):138-141.
  • Rogha M, Nikvarz M, Pourmoghaddas Z, Shirneshan K, Dadkhah D, Pourmoghaddas M. Is helicobacter pylori infection a risk factor for coronary heart disease?. ARYA Atheroscler. 2012;8(1):5-8.
  • Kowalski M, Konturek PC, Pieniazek P, et al. Prevalence of Helicobacter pylori infection in coronary artery disease and effect of its eradication on coronary lumen reduction after percutaneous coronary angioplasty. Dig Liver Dis. 2001;33(3):222-229. doi:10.1016/s1590-8658(01)80711-8
  • Sandifer QD, Vuilo S, Crompton G. Association of Helicobacter pylori infection with coronary heart disease. Association may not be causal. BMJ. 1996;312(7025):251. doi:10.1136/bmj.312.7025.251a
  • Danesh J, Peto R. Risk factors for coronary heart disease and infection with Helicobacter pylori: meta-analysis of 18 studies. BMJ. 1998;316(7138):1130-1132. doi:10.1136/bmj.316.7138.1130
  • Zhang S, Guo Y, Ma Y, Teng Y. Cytotoxin-associated geneA-seropositive virulent strains of Helicobacter pylori and atherosclerotic diseases: a systematic review. Chin Med J (Engl). 2008;121(10):946-951.
  • Niccoli G, Franceschi F, Cosentino N, et al. Coronary atherosclerotic burden in patients with infection by CagApositive strains of Helicobacter pylori. Coron Artery Dis. 2010;21(4):217-221. doi:10.1097/MCA.0b013e3283399f36
  • Franceschi F, Niccoli G, Ferrante G, et al. CagA antigen of Helicobacter pylori and coronary instability: insight from a clinico-pathological study and a meta-analysis of 4241 cases. Atherosclerosis. 2009;202(2):535-542. doi:10.1016/j.atherosclerosis.2008.04.051
  • Ikeda A, Iso H, Sasazuki S, Inoue M, Tsugane S; JPHC Study Group. The combination of Helicobacter pylori-and cytotoxinassociated gene-A seropositivity in relation to the risk of myocardial infarction in middle-aged Japanese: The Japan Public Health Center-based study. Atherosclerosis. 2013;230(1):67-72. doi:10.1016/j.atherosclerosis.2013.06.013
  • Eskandarian R, Ghorbani R, Shiyasi M, Momeni B, Hajifathalian K, Madani M. Prognostic role of Helicobacter pylori infection in acute coronary syndrome: a prospective cohort study. Cardiovasc J Afr. 2012;23(3):131-135. doi:10.5830/CVJA-2011-016
  • Elizalde JI, Pérez-Pujol S, Heras M, et al. Effects of Helicobacter pylori eradication on platelet activation and disease recurrence in patients with acute coronary syndromes. Helicobacter. 2004;9(6):681-689. doi:10.1111/j.1083-4389.2004.00271.x
  • Malfertheiner P, Mégraud F, O’Morain C, et al. Current European concepts in the management of Helicobacter pylori infection the Maastricht Consensus Report. The European Helicobacter Pylori Study Group (EHPSG). Eur J Gastroenterol Hepatol. 1997;9(1):1-2. doi:10.1097/00042737-199701000-00002
  • Singla S, Sachdeva R, Uretsky BF. The risk of adverse cardiac and bleeding events following noncardiac surgery relative to antiplatelet therapy in patients with prior percutaneous coronary intervention. J Am Coll Cardiol. 2012;60(20):2005-2016. doi:10.1016/j.jacc.2012.04.062
  • Abraham NS, Hlatky MA, Antman EM, et al. ACCF/ACG/AHA 2010 expert consensus document on the concomitant use of proton pump inhibitors and thienopyridines: a focused update of the ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use. A Report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents. J Am Coll Cardiol. 2010;56(24):2051-2066. doi:10.1016/j.jacc.2010.09.010
  • Vilariño-Rico J, Fariña-Casanova X, Martínez-Gallego EL, et al. The Influence of the Socioeconomic Status and the Density of the Population on the Outcome After Peripheral Artery Disease. Ann Vasc Surg. 2023;89:269-279. doi:10.1016/j.avsg.2022.09.049
  • Ridker PM, Danesh J, Youngman L, et al. A prospective study of Helicobacter pylori seropositivity and the risk for future myocardial infarction among socioeconomically similar U.S. men. Ann Intern Med. 2001;135(3):184-188. doi:10.7326/0003-4819-135-3-200108070-00010
  • Marietti M, Gasbarrini A, Saracco G, Pellicano R. Helicobacter pylori infection and diabetes mellitus: the 2013 state of art. Panminerva Med. 2013;55(3):277-281.
  • Wang F, Liu J, Lv Z. Association of Helicobacter pylori infection with diabetes mellitus and diabetic nephropathy: a meta-analysis of 39 studies involving more than 20,000 participants. Scand J Infect Dis. 2013;45(12):930-938. doi:10.3109/00365548.2013.844351
  • Whincup PH, Mendall MA, Perry IJ, Strachan DP, Walker M. Prospective relations between Helicobacter pylori infection, coronary heart disease, and stroke in middle aged men. Heart. 1996;75(6):568-572. doi:10.1136/hrt.75.6.568
  • Brown LM. Helicobacter pylori: epidemiology and routes of transmission. Epidemiol Rev. 2000;22(2):283-297. doi:10.1093/oxfordjournals.epirev.a018040
  • Min BJ, Seo ME, Bae JH, Kim JW, Kim JH. Development and validation of next-generation sequencing panel for personalized Helicobacter pylori eradication treatment targeting multiple species [published correction appears in Front Cell Infect Microbiol. 2024 Oct 25;14:1502072. doi: 10.3389/fcimb.2024.1502072]. Front Cell Infect Microbiol. 2024;14:1379790. Published 2024 Aug 29. doi:10.3389/fcimb.2024.1379790
There are 39 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases, Clinical Sciences (Other)
Journal Section Research Articles
Authors

Nur Ozer Sensoy 0000-0001-8809-2250

Selman Unverdi This is me 0000-0003-1902-2675

Publication Date February 15, 2025
Submission Date September 25, 2024
Acceptance Date November 10, 2024
Published in Issue Year 2025 Volume: 2 Issue: 1

Cite

Vancouver Sensoy NO, Unverdi S. Association of helicobacter pylori infection with coronary artery disease and the severity of angiographic lesions. Cerasus J Med. 2025;2(1):38-4.