Ischaemic heart disease and Cag A strains of Helicobacter pylori in the Caerphilly heart disease study

Abstract

Objective-To look for the presence of the more virulent strains of Helicobacter pylori (H pylori) in men who developed ischaemic heart disease over a 10 year period and in controls. Design-The Caerphilly prospective heart disease study recruited 2512 men aged 45-59 years during 1979-83. Western blot analysis or enzyme linked immunosorbent assay (ELISA) was performed on serum taken from those who subsequently died of ischaemic heart disease, or developed non-fatal myocardial infarction, to determine H pylori and Cag A status. Similar information was available on age matched controls. Results-During the first decade of the study, 312 men died of ischaemic heart disease or developed non-fatal myocardial infarction. Serum was available from 172 of these (55%). There was no evidence of an association between Cag A seropositivity and incident ischaemic heart disease or ischaemic heart disease mortality, either before or after adjustment for potential confounders (adjusted odds ratios 1.18 (95% confidence interval (CI) 0.76 to 1.85) and 1.13 (95% CI 0.61 to 2.07), respectively). Further, the odds ratios for ischaemic heart disease incidence and ischaemic heart disease mortality by H pylori seropositivity did not appear to depend on the presence or absence of Cag A strains (p = 0.76 and 0.77, respectively). Conclusions-In this cohort of middle aged men, followed over a 10 year period, there is little evidence of an association between Cag A seropositivity and either incident ischaemic heart disease or ischaemic heart disease mortality. (Heart 2001;86:506-509)

Association between Helicobacter. pylori and coronary artery disease

“…While these results are similar to some previously published studies [5,8,[16][17][18][19][20], it is not concordant with others [9,[21][22][23][24][25][26][27][28]. It is worth repeating that this discrepancy seems to have arisen from the previously various methods of evaluating H.pylori infection and atherosclerosis.…”

“…However, some studies have reported association with atherosclerosis [3,26,28,35], some others have reported the non-significant role of anti-Cag A antibody in ischemic heart disease [5,7,36]. Future studies are required to shed sufficient light upon this particular point.…”

“…Several studies have thus far sought to identify the predictors of atherosclerosis, with more recent publications focusing on the inflammatory effects of infectious agents such as Chlamyda.pneumoniae and Helicobacter.pylori (H.pylori) on atherosclerosis. Despite all those efforts, however, controversy still abounds about the role of H.pylori as a determinant factor of atherosclerosis and ischemic disease [3][4][5][6][7][8][9].…”

Interleukin‐18 and gestosis: correlation with Helicobacter pylori seropositivity

“…In fact, about 80% of our pre-eclamptic patients showed a seropositivity for H. pylori pathogenic strains. The same bacteria expressing the Cag-A protein seem indeed to correlate with vascular disease 11,12 and with some inflammatory diseases. 13 Also, some endothelial damage seems to occur at the placental level that is associated with inflammatory mechanisms and can be involved in the pathogenesis of PE.…”

Coronary atherosclerotic burden in patients with infection by CagA-positive strains of Helicobacter pylori

“…Interestingly, several studies have reported CagA-positive strains of H. pylori to increase the risk of myocardial infarction among healthy men [9][10][11] and a recent metaanalysis showed that infection sustained by those strains may be considered as a marker of vascular damage for both coronary and cerebral vessels [4]. Furthermore, infection by CagA-positive strains has been associated with aortic atherosclerosis [6] and an increased intima-medial thickness of the carotid artery [12].…”