Impact of iron status and inflammatory indices on atherosclerotic burden of patients with helicobacter pylori infection and coronary arterial disease Iron Deficiency, HP Infection And CAD Burden

Main Article Content

Baris Sensoy
Nur Ozer Sensoy

Abstract

Objective: Both inflammation and iron deficiency are suggested to be associated with coronary arterial diseases (CAD) and H. Pylori infection. The explanatory interaction depending on serum iron status and inflammatory biomarkers for the extent of atherosclerosis in H. Pylori infection is obscure. Therefore, we aimed to analyze the impact of iron Status and inflammatory indices on atherosclerotic burden of seropositive CAD patients with CagA (cytotoxin-associated gene A) strains of H. Pylori.


Materials and Methods: This was an observational study of patients' undergone elective and urgent coronary angiography due to CAD. Serologic H. pylori infection status and iron status was determined in all of 293 subjects. Further seropositive patients were divided into groups to evaluate the extent of coronary atherosclerosis according to Syntax scoring system. Propensity score matching and covariate- adjusted multivariate logistic regression were used to adjust for baseline differences between study groups.


Results: The odds ratio of positive serology for the presence of iron deficiency and acute coronary syndromes were 2.5 (95% CI (1.1-5.4); p = 0.02) and 3.0 (95% CI (1.3-7.0); p = 0.007) respectively. After controlling for diabetes mellitus, smoking, MPV, RDW and haemoglobin levels; Tsat ≤ 24.5 remained negatively associated with advanced atherosclerosis (OR:9.9, 95% CI (4.1-24.3); p < 0.0001). In our matched sample, multivariable linear regression analysis showed that association of syntax score with Tsat was independent of hs-CRP  (p=0.001).


Conclusions: Irrespective of inflammatory status, transferrin saturation can be the decisive mirror indicator of advanced atherosclerosis in seropositive CAD patients with CagA strains of H. Pylori.

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How to Cite
Sensoy, B., & Sensoy, N. O. (2021). Impact of iron status and inflammatory indices on atherosclerotic burden of patients with helicobacter pylori infection and coronary arterial disease: Iron Deficiency, HP Infection And CAD Burden. Medical Science and Discovery, 8(7), 401–410. https://doi.org/10.36472/msd.v8i7.559
Section
Research Article
Received 2021-06-11
Accepted 2021-06-20
Published 2021-07-01

References

Murray LJ, Bamford KB, O'Reilly DP, McCrum EE, Evans AE. Helicobacter pylori infection: relation with cardiovascular risk factors, ischaemic heart disease, and social class. British heart journal 1995;74:497-501.

Kowalski M. Helicobacter pylori (H. pylori) infection in coronary artery disease: influence of H. pylori eradication on coronary artery lumen after percutaneous transluminal coronary angioplasty. The detection of H. pylori specific DNA in human coronary atherosclerotic plaque. Journal of physiology and pharmacology : an official journal of the Polish Physiological Society 2001;52:3-31.

Haider AW, Wilson PW, Larson MG, Evans JC, Michelson EL, Wolf PA, O'Donnell CJ et al. The association of seropositivity to Helicobacter pylori, Chlamydia pneumoniae, and cytomegalovirus with risk of cardiovascular disease: a prospective study. Journal of the American College of Cardiology 2002;40:1408-13.

Ikeda A, Iso H, Sasazuki S, Inoue M, Tsugane S; JPHC Study Group. The combination of Helicobacter pylori- and cytotoxin-associated gene-A seropositivity in relation to the risk of myocardial infarction in middle-aged Japanese: The Japan Public Health Center-based study. Atherosclerosis 2013;230:67-72.

Niccoli G, Franceschi F, Cosentino N, Giupponi B, De Marco G, Merra G et al. Coronary atherosclerotic burden in patients with infection by CagA-positive strains of Helicobacter pylori. Coronary artery disease 2010;21:217-21.

Elizalde JI, Pérez-Pujol S, Heras M, Sionis A, Casanovas N, Martorell Tet al. Effects of Helicobacter pylori eradication on platelet activation and disease recurrence in patients with acute coronary syndromes. Helicobacter 2004;9:681-9.

Eskandarian R, Ghorbani R, Shiyasi M, Momeni B, Hajifathalian K, Madani M. Prognostic role of Helicobacter pylori infection in acute coronary syndrome: a prospective cohort study. Cardiovascular journal of Africa 2012;23:131-5.

Strachan DP, Mendall MA, Carrington D, Butland BK, Yarnell JW, Sweetnam PM et al. Relation of Helicobacter pylori infection to 13-year mortality and incident ischemic heart disease in the caerphilly prospective heart disease study. Circulation 1998;98:1286-90.

Franceschi F, Niccoli G, Ferrante G, Gasbarrini A, Baldi A, Candelli M et al. CagA antigen of Helicobacter pylori and coronary instability: insight from a clinico-pathological study and a meta-analysis of 4241 cases. Atherosclerosis 2009;202:535-42.

Malfertheiner P, Megraud F, O'Morain CA, Atherton J, Axon AT, Bazzoli F et al. Management of Helicobacter pylori infection--the Maastricht IV/ Florence Consensus Report. Gut 2012;61:646-64.

González CA, Figueiredo C, Lic CB, Ferreira RM, Pardo ML, Ruiz Liso JM et al. Helicobacter pylori cagA and vacA genotypes as predictors of progression of gastric preneoplastic lesions: a long-term follow-up in a high-risk area in Spain. The American journal of gastroenterology 2011;106:867-74.

Muhsen K, Cohen D. Helicobacter pylori infection and iron stores: a systematic review and meta-analysis. Helicobacter 2008;13:323-40.

Saadat I, Higashi H, Obuse C, Umeda M, Murata-Kamiya N, Saito Y et al. Helicobacter pylori CagA targets PAR1/MARK kinase to disrupt epithelial cell polarity. Nature 2007;447:330-3.

Mørkedal B, Laugsand LE, Romundstad PR, Vatten LJ. Mortality from ischaemic heart disease: sex-specific effects of transferrin saturation, serum iron, and total iron binding capacity. The HUNT study. European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology 2011;18:687-94.

Jankowska EA, Wojtas K, Kasztura M, Mazur G, Butrym A, Kalicinska E et al. Bone marrow iron depletion is common in patients with coronary artery disease. International journal of cardiology 2015;182:517-22.

Das De S, Krishna S, Jethwa A. Iron status and its association with coronary heart disease: systematic review and meta-analysis of prospective studies. Atherosclerosis 2015;238:296-303.

Sansanayudh N, Anothaisintawee T, Muntham D, McEvoy M, Attia J, Thakkinstian A. Mean platelet volume and coronary artery disease: a systematic review and meta-analysis. International journal of cardiology 2014;175:433-40.

Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD et al. Third universal definition of myocardial infarction. Circulation 2012;126:2020-35.

Mader R, Koton Y, Buskila D, Herer P, Elias M. Serum iron and iron stores in non-anemic patients with fibromyalgia. Clinical rheumatology 2012;31:595-9.

Trpkovic A, Stanimirovic J, Rizzo M, Resanovic I, Soskic S, Jevremovic D et al. High-Sensitivity C-Reactive Protein and Statin Initiation. Angiology 2015;66:503-7.

Matsukura N, Onda M, Tokunaga A, Kato S, Yamashita K, Ohbayashi M. Detection of Helicobacter pylori DNA in gastric juice by the polymerase chain reaction: comparison with findings in bacterial culture and the detection of tissue IgA and serum IgG antibodies against Helicobacter pylori. Journal of gastroenterology 1995;30:689-95.

Serruys PW, Onuma Y, Garg S, Sarno G, van den Brand M, Kappetein AP et al. Assessment of the SYNTAX score in the Syntax study. EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology 2009;5:50-6.

SYNTAX Working Group. SYNTAX score calculator. http://www.syntaxscore.com.

Rubin DB. The design versus the analysis of observational studies for causal effects: parallels with the design of randomized trials. Statistics in medicine 2007;26:20-36.

Ozaydin N, Turkyilmaz SA, Cali S. Prevalence and risk factors of Helicobacter pylori in Turkey: a nationally-representative, cross-sectional, screening with the (1)(3)C-Urea breath test. BMC public health 2013;13:1215.

Tamer GS, Tengiz I, Ercan E, Duman C, Alioglu E, Turk UO. Helicobacter pylori seropositivity in patients with acute coronary syndromes. Digestive diseases and sciences 2009;54:1253-6.

Khurshid A, Fenske T, Bajwa T, Bourgeois K, Vakil N. A prospective, controlled study of Helicobacter pylori seroprevalence in coronary artery disease. The American journal of gastroenterology 1998;93:717-20.

Marietti M, Gasbarrini A, Saracco G et al. Helicobacter pylori infection and diabetes mellitus: the 2013 state of art. Panminerva medica 2013;55:277-81.

Yuan W, Li Y, Yang K, Ma B, Guan Q, Wang D et al. Iron deficiency anemia in Helicobacter pylori infection: meta-analysis of randomized controlled trials. Scandinavian journal of gastroenterology 2010;45:665-76.

Topal F, Karaman K, Akbulut S, Dincer N, Dölek Y, Cosgun Y, et al. The relationship between mean platelet volume levels and the inflammation in Helicobacter pylori gastritis. Journal of the National Medical Association 2010;102:726-30.

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