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      Helicobacter pylori Infection and Coronary Heart Disease in Japanese Patients


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          Although several independent studies have claimed a link between Helicobacter pylori infection and coronary heart disease (CHD), this association has not been established conclusively. The aim was to determine whether an association between H. pylori infection and CHD can be demonstrated in Japanese patients. Three-hundred and four patients who underwent consecutive coronary arteriography were investigated. Ninety-four patients had single-vessel coronary stenosis and 112 had multi-vessel stenosis. The remaining 98 patients had no significant stenosis in any coronary arteries. H. pylori infection 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. pylori was significantly higher in the patients with CHD (67%) than in the controls (50%; p = 0.006). The odds ratio for CHD after having H. pylori infection was estimated as 1.35 (95% confidence interval 1.03–1.78; p = 0.028), after adjustment for the common risk factors of CHD in a logistic regression analysis. The association between CHD and H. pylori infection was more significant among patients without any history of diabetes or smoking. The PG I-II ratio in H. pylori-positive patients was significantly higher in the multi-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 among 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 relevant.

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          An international association between Helicobacter pylori infection and gastric cancer

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            Chlamydia pneumoniae is a risk factor for coronary heart disease in symptom-free elderly men, but Helicobacter pylori and cytomegalovirus are not.

            To test the hypothesis that chronic infection with Chlamydia pneumoniae, Helicobacter pylori or cytomegalovirus is associated with coronary heart disease risk in elderly men, a nested case-control study in a cohort investigated in 1985 and 1990 in the town of Zutphen, The Netherlands, was designed. Fifty-four cases with a first diagnosed coronary event between 1985 and 1990, and 108 age-matched control subjects free of coronary heart disease during follow up were included in the study. The overall prevalence of antibodies to cytomegalovirus was 74.7%, to H. pylori 75.9% and to C. pneumoniae 84.0%. A high level of antibodies to C. pneumoniae was associated with an increased coronary heart disease risk (OR = 2.76; 95% CI = 1.31-5.81). This association was stronger in cases developing both myocardial infarction and angina pectoris, than in cases developing only one of these. This association was independent of potential confounders. Antibodies to cytomegalovirus or H. pylori were not associated with coronary heart disease risk. These results support the hypothesis of a role of chronic C. pneumoniae infections in the immunopathogenesis of atherosclerosis.
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              Radioimmunoassay of serum group I and group II pepsinogens in normal controls and patients with various disorders


                Author and article information

                S. Karger AG
                May 2001
                25 May 2001
                : 95
                : 1
                : 14-19
                Divisions of aIntegrated Medicine, bAtherosclerosis and Metabolism, and cCardiology, Department of Integrated Medicine, Omiya Medical Center, Jichi Medical School, Omiya City; dDepartment of Community and General Medicine, School of Medicine, Sapporo Medical University, Sapporo City, and eDepartment of Gastroenterology, Jichi Medical School, Minamikawachi, Tochigi, Japan
                47337 Cardiology 2001;95:14-19
                © 2001 S. Karger AG, Basel

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                Page count
                Tables: 4, References: 26, Pages: 6
                General Cardiology


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