Helicobacter pylori infection and coronary heart disease in Japanese patients

Although several independent studies have claimed a link between Helicobact er pylori infection and coronary heart disease (CHD), this association has not been established conclusively. The aim was to determine whether an asso ciation between H. pylori infection and CHD can be demonstrated in Japanese patients. Three-hundred and four patients who underwent consecutive corona ry arteriography were investigated. Ninety-four patients had single-vessel coronary stenosis and 112 had multivessel stenosis. The remaining 98 patien ts had no significant stenosis in any coronary arteries. H. pylori infectio n was diagnosed serologically and the association between infection and CHD was estimated by the odds ratio. The serum pepsinogen (PG) I-II ratio was used to estimate the degree of gastric atrophy. Seropositivity for H. pylor i was significantly higher in the patients with CHD (67%) than in the contr ols (50%; p = 0.006). The odds ratio for CHD after having H. pylori infecti on was estimated as 1.35 (95% confidence interval 1.03-1.78; p = 0.028), af ter adjustment for the common risk factors of CHD in a logistic regression analysis. The association between CHD and H. pylori infection was more sign ificant among patients without any history of diabetes or smoking. The PG I -II ratio in H. pylori-positive patients was significantly higher in the mu lti-vessel group (3.46) than in the control or single-vessel group (2.86, p = 0.030; 2.78, p = 0.008; respectively). H. pylori infection was shown to be an independent risk factor for CHD in Japanese patients, especially amon g those who did not have a history of diabetes or smoking. These data imply that the association between H. pylori infection and CHD is clinically rel evant. Copyright (C) 2001 S. Karger AG, Basel.