Helicobacter pylori: Does it add to risk of coronary artery disease

Table 1 Recent reports on association of Helicobacter pylori infection with coronary artery disease

Ref.	Population (number of subjects)	Diagnosis of CAD	Association between H. pylori infection and CAD
Shmuely et al[23]	CAD (173) vs Controls (123)	Myocardial Perfusion imaging	Yes No association with Cag-A
Vafaeimanesh et al[10]	CAD (62) vs Controls (58)	Angiographic	Yes
Laek et al[13]	5744 individuals, Age 45-84 yr, average follow-up of 2.4 yr	Newly detectable coronary artery calcium (CAC)	No correlation with CAC development
Mundkur et al[18]	CAD and controls (433 each) from South Asians	Angiography	None
Padmavati et al[24]	Acute myocardial infarction vs Controls	ECG, enzymes	None
Tewari et al[15]	200 CAD cases and controls	ECG, treatment records	Yes
Grdanoska et al[25]	Acute coronary syndrome (64), CAD (53), controls (35)	ECG, enzymes	Yes
Grub et al[26]	Controls (30), CAD (52) and CAD with rheumatic diseases (67)	Patients referred for CABG	None
Park et al[12]	2029 subjects	CAC	Yes
Al-Ghamdi et al[27]	CAD (50) and controls (15)	ECG, angiography	Yes
Azarkar et al[28]	Controls (78) and myocardial infarction (73)	ECG, enzymes	Yes
Khodaii et al[29]	Myocardial infarction (500) and controls (500)	ECG, enzymes	Yes Cag-A positivity also correlates with CAD

CAD: Coronary artery disease; Cag-A: Cytotoxin associated gene A; ECG: Electrocardiography; CAC: Coronary artery calcium; CABG: Coronary artery bypass grafting; H. pylori: Helicobacter pylori.

Table 2 Effect of Helicobacter pylori eradication on coronary artery disease

Ref.	Population	Intervention	Results
Kowalski et al[47,48]	40 patient with single vessel CAD and H. pylori infection	All underwent PTCA and 20 each received eradication or placebo	Attenuated reduction mean coronary artery lumen at 6 mo in those undergoing eradication
Lu et al[49]	H. pylori positive individuals	Testing of coronary risk factors before and after H. pylori eradication	No change in sugar, lipid and fibrinolytic parameters with eradication
Pellicano et al[50]	H. pylori positive individuals	Testing of coronary risk factors before and after H. pylori eradication	Improvement in HDL-C, reduction in CRP and fibrinogen levels. Elevation in BMI and diastolic blood pressure
Gen et al[51]	H. pylori positive individuals	Testing for insulin resistance, lipid profile and CRP before and after eradication	Improvement in insulin resistance, lipid abnormalities and CRP levels
Kanbay et al[52]	H. pylori positive individuals	Testing for lipid profile and CRP before and after eradication	Increase in HDL and reduction in CRP with successful eradication

CAD: Coronary artery disease; CRP: C-reactive protein; HDL: High density lipoprotein; PTCA: Percutaneous transluminal coronary angioplasty; H. pylori: Helicobacter pylori.