Does H Pylori Increase Atherosclerosis Risk?

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.

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 pyloriinfection, 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 pyloriinfection and subclinical atherosclerosis in a ‘healthy’ population remains to be investigated in the future.”

—Christina Vogt

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