Coronary atherosclerotic burden in patients with infection by CagA-positive strains of Helicobacter pylori

Giampaolo Niccoli, Francesco Franceschi, Nicola Cosentino, Bianca Giupponi, Guido De Marco, Giuseppe Merra, Micaela Conte, Rocco Antonio Montone, Giuseppe Ferrante, Marco Bacà, Antonio Gasbarrini, Nicolò Gentiloni Silveri, Filippo Crea

Research output: Contribution to journalArticle

Abstract

Objectives: Cytotoxic associated gene-A (CagA)-positive strains of Helicobacter pylori emerged as a possible atherosclerotic stimulus. Nevertheless, whether CagA-positivity is associated with more extensive or severe atherosclerotic coronary burden has never been studied. Methods: Forty consecutive patients with coronary artery disease (CAD) and twenty consecutive patients with normal coronary arteries undergoing coronary angiography were enrolled. All patients underwent evaluation of classical atherogenic risk factors and assessment of anti-urease B and anti-CagA antibodies titer. Either the severity of coronary stenosis (stenosis score) or the extent of coronary atherosclerosis (extent score) was evaluated in CAD patients. Results: The anti-CagA antibody titer was significantly higher in patients with CAD as compared with normal coronary arteries patients [85 (10-108.75) vs. 47.3 (17-64)RU/ml, P=0.02], whereas there were no differences in anti-urease B titer between the two groups. A significant correlation was found between anti-CagA antibody titer and extent score (R=0.35, P=0.03), whereas stenosis score was similar (R=0.25, P=0.11). On the contrary, no significant correlation was found between anti-urease B antibody titer and either extent or stenosis score. Moreover, CagA-positive patients had a more extensive CAD (P=0.029) when compared with CagA-negative patients. Interestingly, whereas serum glucose, LDL levels, anti-urease B, and anti-CagA antibodies were predictors of extent score at univariate analysis, at multivariate analysis anti-CagA antibody titer only was an independent predictor of the extent of coronary atherosclerosis (B=0.051, standard error of B=0.042, P=0.04). Conclusion: These results support the association between CagA-positive H. pylori infection and coronary atherosclerotic burden. Further studies are needed to better elucidate the mechanism by which CagA-positive strains may promote atherosclerosis.

Original languageEnglish
Pages (from-to)217-221
Number of pages5
JournalCoronary Artery Disease
Volume21
Issue number4
DOIs
Publication statusPublished - Jun 2010

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Helicobacter pylori
Infection
Coronary Artery Disease
Genes
Urease
Antibodies
Pathologic Constriction
Coronary Vessels
Coronary Stenosis
Helicobacter Infections
Coronary Angiography
Atherosclerosis
Multivariate Analysis
Glucose

Keywords

  • CagA-positive strains
  • Coronary angiography
  • Coronary atherosclerosis
  • Helicobacter pylori
  • Molecular mimicry

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Coronary atherosclerotic burden in patients with infection by CagA-positive strains of Helicobacter pylori. / Niccoli, Giampaolo; Franceschi, Francesco; Cosentino, Nicola; Giupponi, Bianca; De Marco, Guido; Merra, Giuseppe; Conte, Micaela; Montone, Rocco Antonio; Ferrante, Giuseppe; Bacà, Marco; Gasbarrini, Antonio; Silveri, Nicolò Gentiloni; Crea, Filippo.

In: Coronary Artery Disease, Vol. 21, No. 4, 06.2010, p. 217-221.

Research output: Contribution to journalArticle

Niccoli, G, Franceschi, F, Cosentino, N, Giupponi, B, De Marco, G, Merra, G, Conte, M, Montone, RA, Ferrante, G, Bacà, M, Gasbarrini, A, Silveri, NG & Crea, F 2010, 'Coronary atherosclerotic burden in patients with infection by CagA-positive strains of Helicobacter pylori', Coronary Artery Disease, vol. 21, no. 4, pp. 217-221. https://doi.org/10.1097/MCA.0b013e3283399f36
Niccoli, Giampaolo ; Franceschi, Francesco ; Cosentino, Nicola ; Giupponi, Bianca ; De Marco, Guido ; Merra, Giuseppe ; Conte, Micaela ; Montone, Rocco Antonio ; Ferrante, Giuseppe ; Bacà, Marco ; Gasbarrini, Antonio ; Silveri, Nicolò Gentiloni ; Crea, Filippo. / Coronary atherosclerotic burden in patients with infection by CagA-positive strains of Helicobacter pylori. In: Coronary Artery Disease. 2010 ; Vol. 21, No. 4. pp. 217-221.
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AU - De Marco, Guido

AU - Merra, Giuseppe

AU - Conte, Micaela

AU - Montone, Rocco Antonio

AU - Ferrante, Giuseppe

AU - Bacà, Marco

AU - Gasbarrini, Antonio

AU - Silveri, Nicolò Gentiloni

AU - Crea, Filippo

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N2 - Objectives: Cytotoxic associated gene-A (CagA)-positive strains of Helicobacter pylori emerged as a possible atherosclerotic stimulus. Nevertheless, whether CagA-positivity is associated with more extensive or severe atherosclerotic coronary burden has never been studied. Methods: Forty consecutive patients with coronary artery disease (CAD) and twenty consecutive patients with normal coronary arteries undergoing coronary angiography were enrolled. All patients underwent evaluation of classical atherogenic risk factors and assessment of anti-urease B and anti-CagA antibodies titer. Either the severity of coronary stenosis (stenosis score) or the extent of coronary atherosclerosis (extent score) was evaluated in CAD patients. Results: The anti-CagA antibody titer was significantly higher in patients with CAD as compared with normal coronary arteries patients [85 (10-108.75) vs. 47.3 (17-64)RU/ml, P=0.02], whereas there were no differences in anti-urease B titer between the two groups. A significant correlation was found between anti-CagA antibody titer and extent score (R=0.35, P=0.03), whereas stenosis score was similar (R=0.25, P=0.11). On the contrary, no significant correlation was found between anti-urease B antibody titer and either extent or stenosis score. Moreover, CagA-positive patients had a more extensive CAD (P=0.029) when compared with CagA-negative patients. Interestingly, whereas serum glucose, LDL levels, anti-urease B, and anti-CagA antibodies were predictors of extent score at univariate analysis, at multivariate analysis anti-CagA antibody titer only was an independent predictor of the extent of coronary atherosclerosis (B=0.051, standard error of B=0.042, P=0.04). Conclusion: These results support the association between CagA-positive H. pylori infection and coronary atherosclerotic burden. Further studies are needed to better elucidate the mechanism by which CagA-positive strains may promote atherosclerosis.

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