H Pylori Raises Atherosclerosis Risk Even in Healthy Individuals

Helicobacter pylori (H pylori) infection is known to be associated with cardiovascular disease (CVD) in patients with a history of CVD.

Now the authors of a new study say that the presence of H pylori is also associated with significant coronary artery stenosis among healthy individuals without history of CVD.
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For their study, the researchers evaluated 463 patients without previous CVD who had underwent the rapid urease test (CLO test), pulse-wave velocity (PWV) measurement, and cardiac multidetector computed tomography (MDCT) from December 2007 to February 2014.

CLO test positivity on endoscopic gastric biopsy was used to confirm the presence of H pylori infection, and significant coronary artery stenosis was defined as at least 50% stenosis in any major epicardial coronary vessel on MDCT.

Findings revealed that patients who were CLO-positive had a higher incidence of coronary stenosis than patients who were CLO-negative (7.6% vs 2.9%), had lower levels of high-density lipoprotein cholesterol, and had more coronary artery calcium scores above 0.

Ultimately, even after adjustment, results indicated that CLO-positive patients were nearly 3 times more likely to have significant coronary artery stenosis compared with CLO-negative patients (adjusted odds ratio 2.813).

The researchers noted that they did not observe any statistical difference in the number of patients with a coronary artery calcium score above 100 or the prevalence of any plaque or plaque characteristics. Furthermore, they did not find pulse-wave velocity to be associated with CLO test positivity.

“In a healthy population, current H pylori infection was associated with subclinical but significant coronary artery stenosis,” the researchers concluded. “The causal relationship between H pylori infection and subclinical atherosclerosis in a ‘healthy’ population remains to be investigated in the future.”

—Christina Vogt

Reference:

Lee M, Baek H, Park JS, et al. Current Helicobacter pylori infection is significantly associated with subclinical coronary atherosclerosis in healthy subjects: A cross-sectional study [published online March 2, 2018]. PLOS One. https://doi.org/10.1371/journal.pone.0193646.