Effects of Helicobacter pylori Eradication on Platelet Activation and Disease Recurrence in Patients with Acute Coronary Syndromes

Abstract

Infection with H. pylori does not induce significant platelet activation in patients treated for coronary disease. Helicobacter pylori-infected patients, however, may have an increased risk of recurrence of coronary events.

Platelet Activation in <i>Helicobacter pylori</i>-Associated Idiopathic Thrombocytopenic Purpura: Eradication Reduces Platelet Activation but Seldom Improves Platelet Counts

“…Our observation of decreased platelet CD62p expression contrasts with those of Elizalde et al [17] who studied patients with acute coronary syndromes but were unable to identify elevated platelet CD62p expression in patients with H. pylori infection or a reduction in expression following eradication therapy compared with placebo-treated controls. Since all patients were treated for acute coronary syndromes, anti-platelet medications were probably a confounding factor, and the authors acknowledge this possibility in their discussion (one third of the patients were on both clopidogrel and aspirin, and almost all were on aspirin).…”

“…The potential impact of aspirin and clopidogrel on CD62p expression studies on patients with atherosclerosis is also suggested in a study by Klinkhardt et al [25] who demonstrated that CD62p expression was lower in patients on aspirin or clopidogrel compared with controls, although the clopidogrel group was alone in reaching statistical significance. However, Elizalde et al [17] did find that only final H. pylori infectionstatus and coronary risk factors predicted recurrence of cardiovascular events. Our patient population is uniquely favorable to study the effect of H. pylori eradication on platelet CD62p expression, since patients are uniformly advised to avoid anti-platelet therapy due to the hemorrhagic risk associated with low platelet counts.…”

“…However, Elizalde et al [17] were later unable to document either elevated platelet CD62p expression in patients with both acute coronary syndromes and H. pylori infection or reduced CD62p expression following eradication therapy. But the study was confounded by the fact that almost all patients were on anti-platelet therapy, and one third were on both aspirin and clopidogrel.…”

Possible Association of Atrophic Gastritis and Arterial Stiffness in Healthy Middle-Aged Japanese

“…In regards to the relation between HP infection and stroke, positive 12) and negative 13) test results have been reported. It has also been reported that the eradication of HP and antibiotics against HP reduced the recurrence rate of acute coronary events 14,15) . Arterial stiffness is an independent and impor-…”

Danger Signaling in Atherosclerosis

“…36 In addition, H pylori eradication is associated with a reduction of secondary coronary events in patients with CVD. 37 In the South Thames Trial of Antibiotics in Myocardial Infarction and Unstable Angina (STAMINA) trial, a significant reduction in C-reactive protein and improvement in event-free survival was reported with combined treatment for both C pneumoniae and H pylori. 38 However, data from experimental mouse models with C57Bl/6, LDL receptor (LDLR) −/− , or ApoE −/+ and LDLR −/+ mice are controversial and inconclusive.…”