Affiliation:
1. From the Departments of Internal Medicine and Cardiology (V.P., G.C., G.P., L.C., A.G., G.F., G.G., A.M.), Institute of Microbiology (R.L.G.), Catholic University of the Sacred Heart, Rome, Italy.
Abstract
Background
—Previous studies have reported an association between chronic
Helicobacter pylori
infection and ischemic heart disease. However, it is not clear whether this association is really due to the virulence of the bacterium or is merely the result of confounding factors (in particular, age and social class).
Methods and Results
—We assessed the prevalence of infection by
Helicobacter pylori
and by strains bearing the cytotoxin-associated gene-A (CagA), a strong virulence factor, in 88 patients with ischemic heart disease (age, 57±8 years; 74 men) and in 88 age- and sex-matched controls (age, 57±8 years; 74 men) with similar social background. Prevalence of
Helicobacter
infection was significantly higher in patients than in controls (62% versus 40%;
P
=.004), with an odds ratio of 2.8 (95% CI, 1.3 to 7.4;
P
<.001) adjusted for age, sex, main cardiovascular risk factors, and social class. Patients with ischemic heart disease also had a higher prevalence of CagA-positive strains (43% versus 17%;
P
=.0002), with an adjusted odds ratio of 3.8 (95% CI, 1.6 to 9.1;
P
<.001). Conversely, prevalence of CagA-negative strains was similar in patients and controls (19% versus 23%), with an adjusted odds ratio of 0.8 (95% CI, 0.4 to 1.4).
Conclusions
—The association between
Helicobacter pylori
and ischemic heart disease seems to be due to a higher prevalence of more virulent
Helicobacter
strains in patients. These results support the hypothesis that
Helicobacter pylori
may influence atherogenesis through low-grade, persistent inflammatory stimulation.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Physiology (medical),Cardiology and Cardiovascular Medicine
Cited by
258 articles.
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