Cardiovascular medicine
Ischaemic heart disease and Cag A strains of
Helicobacter pylori in the Caerphilly heart
disease study
A F M Stonea, P Risleya, H S Markusb, B K Butlandc, D P Strachanc, P C Elwoodd, M A Mendalle
a Division of
Gastroenterology, Endocrinology and Metabolism, St George's Hospital
Medical School, London SW17, UK, b Department of Clinical Neurosciences, St
George's Hospital Medical School, c Department of Public Health Sciences, St
George's Hospital Medical School, d Medical
Research Council Epidemiology Unit (South Wales), Llandough Hospital,
South Glamorgan, UK, e Mayday
University Hospital, Mayday Rd, Thornton Heath, Surrey CR7 7YE, UK
Correspondence to: Dr Mendall mmendall{at}sghms.ac.uk
Accepted 25 July 2001
OBJECTIVE
To look for the presence of
the more virulent strains of Helicobacter
pylori (H pylori) in men who
developed ischaemic heart disease over a 10 year period and in controls.
DESIGNThe Caerphilly prospective
heart disease study recruited 2512 men aged 45-59 years during
1979-83. Western blot analysis or enzyme linked immunosorbent assay
(ELISA) was performed on serum taken from those who subsequently died
of ischaemic heart disease, or developed non-fatal myocardial
infarction, to determine H pylori and Cag A
status. Similar information was available on age matched controls.
RESULTSDuring the first decade of
the study, 312 men died of ischaemic heart disease or developed
non-fatal myocardial infarction. Serum was available from 172 of these
(55%). There was no evidence of an association between Cag A
seropositivity and incident ischaemic heart disease or ischaemic heart
disease mortality, either before or after adjustment for potential
confounders (adjusted odds ratios 1.18 (95% confidence interval (CI)
0.76 to 1.85) and 1.13 (95% CI 0.61 to 2.07), respectively). Further,
the odds ratios for ischaemic heart disease incidence and ischaemic
heart disease mortality by H pylori
seropositivity did not appear to depend on the presence or absence of
Cag A strains (p = 0.76 and 0.77, respectively).
CONCLUSIONSIn this cohort of middle
aged men, followed over a 10 year period, there is little evidence of
an association between Cag A seropositivity and either incident
ischaemic heart disease or ischaemic heart disease mortality.
Keywords: ischaemic heart disease; epidemiology; infection; Helicobacter pylori
© 2001 by Heart
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