Helicobacter pylori Infection as a Risk Factor for Coronary Artery Disease

Background: Helicobacter pylori (H. pylori) infection is the most common infection in the world and coronary artery disease (CAD) is probably associated with it.

Aim: The aim of this prospective study was to evaluate the association between H. pylori infection and other risk factors with suspected CAD patients and to investigate the influence of H. pylori infection on cardiovascular risk factors (lipid profile and. Highly sensitive C-reactive protein (hs CRP) levels).

Methods: Prospective cross sectional study was conducted to involve one hundred twenty patients with dyspeptic symptoms who involved 60 patients suffering from CAD and 60 controls who attended the gastrointestinal endoscopy clinic of the departments of internal medicine in AL-Quwayiyah General Hospital, Riadh, KSA. The study was carried out for six months from June to - November 2015. H. pylori were detected by rapid urease test, H pylori IgG ELISA test and histopathology. Total cholesterol (TC), high density lipoprotein cholesterol (HDL- c) and triglycerides (TG) were measured by enzymatic methods using an automated chemistry analyzer. Low density lipoprotein cholesterol (LDL- c) was calculated using the Friedewald equation. hs CRP levels were estimated.

Results: H. pylori was confirmed in 80 (66.7%) of total 120 patients and controls by histology (gold method for diagnosis) and 80 (66.7%) by rapid urease test while 75 (62.5%) was detected by serology. There was no significant difference in age, sex or coronary artery risk factors between the two groups, but the prevalence of infectivity for H. pylori was higher in patients compared to controls (47{78.3%} versus 33 {55%} P<0.05). The patients with H. pylori infection had significant high triglyceride, low HDL-c and hs CRP levels than those with negative H. pylori (180.2±64.1, 29.1±7.3 and 14.8±7.8 versus 137.6±48.4, 45.6±8.9 and 9.2±7.1).

Conclusion: H. pylori infection increases the risk of CAD, and should be considered as a risk factor for CAD, also there was significant association between H. pylori infection and increased triglyceride hsCRP levels and decreased HDL-c. Further, prospective large trial is needed to confirm our finding.