Association of helicobacter pylori infection with coronary artery disease and the severity of angiographic lesions

Objective: There are controversies evaluating the association between different strains of Helicobacter pylori (HP) and occurrence of coronary arterial disease (CAD). HP may facilitate gastric ulcers and gastrointestinal bleeding. As angiographic lesions of high thrombus burden needs more potent and risky antithrombotic treatment regimens, we aimed to investigate the role of different strains of HP for angiographic lesions with high thrombus burden. Methods: Medical and drug history of 109 consecutive patients who were candidate for coronary angiography were taken. Blood samples were obtained to measure anti HP (Ig) immunoglobulin G and anti-CagA (cytotoxin-associated gene) IgG antibody. According to angiography reports, participants were divided into three groups. Normal (n = 34), lesions with no thrombus (n=38) and lesions with thrombus (n = 37). To measure the association between CagA positive and less virulan strains of HP with the severity of CAD, ordinal logistic regression tests were used by adjusting age, sex, history of hypertention, diabetes mellitus , dyslipidemia and smoking. Results: The mean ages of patients with and without CAD were 59±14. The prevalence of seropositivity to HP IgG titer was 69% (n=75). Fifty nine (79%) subject had CagA IgG seropositivity. Positive CagA IgG serology was 67% (n=50) and 44% (n=15) in CAD and control groups respectively. While HP IgG serology wasn’t associated with lesion severity; CagA IgG serology was independently associated with lesion severity (OR: 2.4 (1.1-5.6) p=0.03). Conclusion: Colonization of CagA positive HP was an independent risk factor for angiographic lesion severity..