Current Helicobacter pylori infection is significantly associated with subclinical coronary atherosclerosis in healthy subjects: A cross-sectional study

Abstract

Helicobacter pylori is a gastrointestinal pathogen known to be associated with cardiovascular disease (CVD). However, most analyses about the effect of H. pylori infection have been done in patients with a history of CVD but not in healthy subjects. We evaluated the association between H. pylori infection and subclinical atherosclerosis by using cardiac multidetector computed tomography (MDCT) in healthy subjects without previous CVD. From December 2007 to February 2014, 463 subjects who underwent the rapid urease test (CLO test), pulse-wave velocity (PWV) measurement, and MDCT for a self-referred health check-up were enrolled to this study. Helicobacter pylori infection was defined on the basis of CLO test positivity on endoscopic gastric biopsy. Significant coronary artery stenosis was defined as ≥50% stenosis in any of the major epicardial coronary vessel on MDCT. The CLO-positive subjects had a lower high-density lipoprotein-cholesterol (HDL-cholesterol) level compared to the CLO-negative subjects. The incidence of significant coronary stenosis was higher in the CLO-positive group (7.6% vs. 2.9%, P = 0.01). Furthermore, the number of subjects with coronary artery calcium score >0 and log{(number of segments with plaque)+1} were also significantly higher in the CLO-positive group. However, there was no statistical difference in the number of subjects with coronary artery calcium score >100, the prevalence of any plaque nor the plaque characteristics (calcified, mixed, or soft). Pulse-wave velocity (PWV) was neither associated with CLO test positivity. The CLO-positive group was 3-fold more likely to have significant coronary artery stenosis even after adjusting for confounding factors (adjusted odds ratio 2.813, 95% confidence interval 1.051–7.528, P = 0.04). In a healthy population, current H. pylori infection was associated with subclinical but significant coronary artery stenosis. The causal relationship between H. pylori infection and subclinical atherosclerosis in a “healthy” population remains to be investigated in the future.

Helicobacter pylori and extragastric diseases

“…Interestingly, arterial hypertension and renal disease were significantly associated with the absence of H. pylori eradication. Another study by Lee et al 3…”

“…Interestingly, arterial hypertension and renal disease were significantly associated with the absence of H. pylori eradication. Another study by Lee et al tested the association between H. pylori infection and subclinical atherosclerosis, using a multidetector computed tomography (MDTC) in subjects without previous history of cardiovascular diseases (CVD). They enrolled 463 subjects who underwent upper GI endoscopy with rapid urease test (CLO test), pulse wave velocity (PWV) measurement, and MDCT.…”

The Efficacy of Berberine-Containing Quadruple Therapy on Helicobacter Pylori Eradication in China: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

“…In China, the infection rate of H. pylori is 40%-60% (Chen et al, 2019). In recent years, in addition to its role in gastrointestinal diseases, several nongastric issues have been found to have a close relationship with H. pylori infection (Adachi et al, 2018;Yong and Upala, 2018;Lee et al, 2018). H. pylori treatment relies on a combination of antimicrobial agents, such as amoxicillin, clarithromycin, metronidazole, and antisecretory agents, such as proton pump inhibitors (PPIs) (Yang and Lu, 2014).…”

Anti-Glycan Autoantibodies Induced by Helicobacter pylori as a Potential Risk Factor for Myocardial Infarction

“…A number of immunological and experimental studies have demonstrated the importance of inflammation in the initiation and progression of atherosclerosis, including the final thrombotic occlusion (1,2). Considerable evidence has emerged that this inflammatory process is sustained, at least in part, by bacteria or viruses, particularly Chlamydia pneumoniae (3), H. pylori (4,5), and Cytomegalovirus (6). It has been proposed that the effect of infection on the vascular wall may be direct, or indirect, by inducing an autoimmune inflammatory response (7).…”

“…Although the published data so far are not entirely concordant, recent analysis of previous studies have provided convincing evidence of a possible role of H. pylori (21,22). Recent studies have also demonstrated a trend toward a decrease in the occurrence of CHD after H. pylori eradication (23) and association between H. pylori infection with subclinical significant coronary artery stenosis in a healthy population (5).…”