CagA Positive Helicobacter Pylori Infection in Coronary Atherosclerosis: Discriminative value of lymphocyte to mean platelet volume ratio.

Abstract

Aim: Potent combined and long-term antithrombotic therapies that predispose to gastric injury are the mainstay of treatment in acute coronary syndromes (ACS). Severe chronic gastric mucosal inflammation due to the Helicobacter Pylori (H. pylori) infection was shown to be associated with higher peripheral blood lymphocytes and lower blood mean platelet volume (MPV) levels. We aimed to investigate the discriminative usefulness of blood lymphocyte to MPV ratio as a simple premise marker for CagA positive H. Pylori infection before the required advanced diagnostic tests in patients with coronary arterial disease (CAD). Materials and Methods: A total of 293 patients’ who had undergone elective and urgent coronary angiography due to CAD were included in the study. Serologic H. pylori infection status and hematological parameters were determined. Two groups were compared according to CagA serology status. Confounding factors were adjusted by propensity score matching and multivariate logistic regression analysis. Results: Rates of ACS, male gender, diabetes mellitus, family history of CAD, current smoking and lymphocyte to MPV ratio were higher in seropositive patients according to seronegative patients (p < 0.05). The ROC curve analysis showed that the lymphocyte to MPV ratio at a cut-off point of 165 had 71% sensitivity and 60% specificity for discriminating patients with positive H. pylori serology (AUC = 0.71, p < 0.0001). Lymphocyte to MPV ratio was independently associated with positive H. Pylori serology. Conclusion: Lymphocyte to MPV ratio can be helpful for discriminating CagA positive H pylori infected CAD patients requiring advanced confirmatory tests.

Keywords

• coronary arterial disease
• H.Pylori
• CagA
• lymphocytes
• mean platelet volume.

Koroner Aterosklerozda CagA Pozitif Helicobacter pylori Enfeksiyonu: Lenfosit Sayısının Ortalama Trombosit Hacmine Oranının Tanısal Değeri

Abstract

Amaç: Akut koroner sendromlarda (AKS) mideye hasar verebilen uzun
süreli güçlü-ikili antitrombotik tedavi kullanılmaktadır. Helicobacter
pylori (H. pylori) enfeksiyonuna bağlı şiddetli kronik gastrik mukozal
inflamasyonun, daha yüksek sayıda periferik kan lenfositleri ve daha
düşük kan ortalama trombosit hacmi (MPV) seviyeleri ile ilişkili olduğu
gösterilmiştir. Koroner arter hastalığı (KAH) olan hastalarda gerekli
ileri tanı testlerinden önce CagA pozitif H. pylori enfeksiyonu varlığını
belirlemede kan lenfosit/MPV oranının öncül belirteç olarak ayırt edici
yararlılığını araştırmayı amaçladık.
Gereç ve Yöntem: KAH nedeniyle elektif ve acil koroner anjiyografi
yapılan toplam 293 hasta çalışmaya dahil edildi. Serolojik H. pylori
enfeksiyon durumu ve hematolojik parametreler belirlendi. CagA
seroloji durumuna göre iki grup karşılaştırıldı. Etkin faktörler, eğilim
skoru eşleştirmesi ve çok değişkenli lojistik regresyon analizi ile
ayarlandı
Bulgular: AKS, erkek cinsiyet, diabetes mellitus, ailede KAH öyküsü,
halen sigara kullanımı ve lenfosit/MPV oranı seropozitif hastalarda
seronegatif hastalara göre daha yüksekti (p<0.05). ROC eğrisi analizi,
lenfosit/MPV oranının 165 kestirim noktası için pozitif H. pylori
serolojisi olan hastaları ayırt etmede %71 duyarlılığa ve %60 özgüllüğe
sahip olduğunu göstermiştir (AUC=0.71, p<0.0001). Lenfosit/MPV
oranı bağımsız olarak pozitif H. pylori serolojisi ile ilişkiliydi.
Sonuç: Lenfosit/MPV oranı, CagA pozitif H. pylori açısından İleri
yöntemler ile taranması gereken KAH hastalarını ayırt etmede yardımcı
olabilir.

Keywords

• CagA
• Koroner Arter Hastalığı
• H. Pylori
• lenfositler
• ortalama trombosit hacmi

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