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IMPACT OF HELICOBACTER PYLORI ON PROGNOSIS OF PATIENTS WITH ACUTE CORONARY SYNDROME

IMPACT OF HELICOBACTER PYLORI ON PROGNOSIS OF PATIENTS WITH ACUTE CORONARY SYNDROME

Rahime Eskandarian MD, Shahrokh Moosavi MD, Mehdi Babai MD, Jafar Toussy MD Raheb Ghorbani MD, Mojtaba Malek MD, Mohsen Shiasi MD, Behroz Momeni MD Ali Ghasemi MD, Azade Vatani MD, Mehrdad Zahmatkesh BS

Abstract
INTRODUCTION: Coronary artery disease (CAD) is the main cause of mortality in industrial and developing countries. New risk factors including infections are under investigation as potential factors. One of these infectious agents is Helicobacter pylori, which has been investigated in numerous studies. This study was designed in view of the controversies surrounding the impact of Helicobacter pylori on the prognosis of patients with acute coronary syndrome (ACS). METHODS: All patients with ACS including unstable angina and myocardial infarction who were referred to Fatemieh Hospital between 20 February 2003 and 19 February 2004 and were admitted to the CCU ward were enrolled in this cohort study. A total of 411 patients with ACS were evaluated for Helicobacter pylori serologically, and the occurrence of cardiac events needing angioplasty or coronary surgery was assessed. RESULTS: Mean age of patients was 59.97±38.12 years and 56% of them were male. The serology test for Helicobacter pylori infection was positive in 45.6±12.38%, negative in 43.8%, and borderline in 10.6% of patients. 191 patients had unstable angina and 220 patients had myocardial infarction. In a one-month follow-up, 10% of the patients developed cardiac events and PCI or CABG was performed in 6.1% (16.1% totally). One-month occurrence of cardiac events in the group with Helicobacter pylori infection was 11.9% vs. 19.3% in the group without infection (χ2 =3.078, P=0.079). DISCUSSION: This prospective study showed that Helicobacter pylori infection has no effect on short term prognosis of patients with ACS.

ARYA Journal, 2006, 1(3): 164-169

oronary artery disease (CAD) is the main cause of mortality in industrial and developing countries.1,2 Several risk factors such as cigarette smoking, hypertension, hyperlipidemia and diabetes have been proposed.3,4 In some patients, no risk factor is found. These patients should be investigated for other risk factors such as infections.

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Keywords • Helicobacter pylori • Acute coronary syndrome • Prognosis

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corresponding author
Rahime Eskandarian, Internal Medicine Research Center, Fatemieh Hospital, 17th Shahrivar Blvd, Semnan, Iran Tel: +98-231-3341449; Fax: 3328302 Email: rheskandarian@yahoo.com

164 ARYA Journal 2006 (Fall); Volume 1, Issue 3

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Infectious agents like Chlamydia pneumonia, Cytomegalovirus, Herpes simplex and Helicobacter pylori (H. pylori) may have a probable role,5,9 but no definitive cause and effect correlation between these agents and unstable angina (UA) or myocardial infection (MI) has yet been approved.10,11 The role of Chlamydia pneumonia as a potentially important and treatable cause for UA or MI is under investigation.12-16 Many researchers have probed the role of H. pylori as a potential risk factor for CAD17-20 and some studies have pointed to an association between H. pylori and CAD.3,6,7,16,23-30 After modification of other cardiac risk factors in some studies, the role of H. pylori

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IMPACT OF HELICOBACTER PYLORI ON PROGNOSIS OF PATIENTS WITH ACUTE CORONARY SYNDROME

FIGURE 1. Prevalence of major risk factors of ischemic heart disease in patients with unstable angina and myocardial infarction

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in the development of CAD weakened or disappeared.5,32-34 A number of studies have ruled out H. pylori as a risk factor for coronary disease.35-38 In some studies, the rate of positive serology tests for H. pylori has been greater in the control group.36 Although H. pylori has been proposed as a probable cause...
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