HELICOBACTER-PYLORI SEROPOSITIVITY AND CORONARY HEART-DISEASE INCIDENCE

FOLSOM AR NIETO FJ SORLIE P CHAMBLESS LE GRAHAM DY

Ar. Folsom et al., HELICOBACTER-PYLORI SEROPOSITIVITY AND CORONARY HEART-DISEASE INCIDENCE, Circulation, 98(9), 1998, pp. 845-850

47

INGLESE

Article

Peripheal Vascular Diseas",Hematology,"Cardiac & Cardiovascular System

Circulation → ACNP

0009-7322

98

9

1998

845 - 850

ISI

0009-7322(1998)98:9<845:HSACHI>2.0.ZU;2-S

Background-Several epidemiological and clinical reports have suggested seropositivity for Helicobacter pylori may be a risk factor for coron ary heart disease. However, there has been no prospective study of thi s association involving an ethnically diverse sample of middle-aged me n and women. Methods and Results-Using a prospective, case-cohort desi gn, we determined H pylori seropositivity in relation to coronary hear t disease incidence over a median follow-up period of 3.3 years among middle-aged men and women. There were 217 incident coronary heart dise ase cases and a cohort sample of 498. We determined H pylori antibody status by measuring IgG antibody to the high-molecular-weight cell-ass ociated proteins of H pylori using a sensitive and specific ELISA. The prevalence of H pylori seropositivity was higher in blacks than white s, in those with less than high school education, in those with lower plasma pyridoxal 5'-phosphate and higher homocyst(e)ine concentrations , in those who did not use vitamin supplements, in those with higher f ibrinogen levels, and in those seropositive for cytomegalovirus and he rpes simplex type I (all P<0.05). The age-, sex-, race-, and field cen ter-adjusted hazard ratio of coronary heart disease for H pylori serop ositivity was 1.03 (95% CI=0.68 to 1.57). After adjustment for other r isk factors, including fibrinogen, cytomegalovirus seropositivity, and herpes simplex type I seropositivity, the hazard ratio was 0.85 (95% CI=0.43 to 1.69), H pylori seropositivity also was not associated with increased mean intima-media thickness of the carotid artery, a measur e of subclinical atherosclerosis, Conclusions-H pylori infection is pr obably not an important contributor to clinical coronary heart disease events.