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Panminerva Medica 1999 December;41(4):279-82


lingua: Inglese

Patients with acute myocardial infarction in Northern Italy are often infected by Helicobacter pylori

Pellicano R., Parravicini P. P.*, Bigi R.**, La Rovere M. T.*, Baduini G.***, Gandolfo N.***, Casaccia M.**, Reforzo F.****, Santoriello L.****, Aruta E.°, Marenco G.****, Arena V., Bazzoli F.°°, Rizzetto M., Ponzetto A.

From the Department of Gastroenterology and * Cardiology Molinette Hospital, Turin ** Medicine, Morelli Hospital, Sondalo *** Mauriziano Hospital, Turin **** Medicine and Laboratory, Pietra Ligure Hospital ° Cardiology Giovanni Bosco Hospital, Turin °° Chair Gastroenterology University of Bologna, Italy


Background. The clas­si­cal ­risk fac­tors for ­acute myo­car­dial infarc­tion (AMI) ­fail to ­explain all the epi­dem­i­olog­i­cal vari­a­tions of the dis­ease. Among the new ­risk fac­tors recent­ly report­ed, sev­er­al infec­tious ­agents ­appear to ­increase the ­risk of AMI. In par­tic­u­lar, ­acute and chron­ic res­pir­a­to­ry dis­eas­es due to Chlamydia pneu­mon­i­ae, and Helicobacter pylo­ri (H. pylo­ri) infec­tion ­seem to be strong­ly ­involved. The aim of this work is to deter­mine the prev­a­lence of H. pylo­ri infec­tion in a ­group of ­male ­patients ­with AMI, in a ­case-con­trol ­study, ­where a ­group of ­blood ­donors ­matched for sex and age ­served as con­trol. We ­searched for the clas­si­cal ­risk fac­tors in all ­patients.
Methods. We stud­ied 212 con­sec­u­tive ­male ­patients, ­aged 40-65 ­years, admit­ted for AMI at the Coronary Care Units at Hospitals in ­three ­towns of Northern Italy. H. pylo­ri infec­tion was ­assessed by the high­ly spe­cif­ic and sen­si­tive 13C-­urea ­breath ­test and by pres­ence of anti­bod­ies (IgG) ­against H. pylo­ri in cir­cu­la­tion. Volunteer ­blood ­donors attend­ing our Hospital Blood Bank ­served as con­trols. Among the ­patients we inves­ti­gat­ed the pres­ence of hyper­ten­sion, cho­les­te­rol and glu­cose lev­els in ser­um, fibrino­gen in plas­ma and the smok­ing hab­it.
Results. H. pylo­ri infec­tion was ­present in 187/212 (88%) of the ­patients and in 183/310 (59%) of the con­trol pop­u­la­tion (p<0.0001). Classical ­risk fac­tors for AMI did not dif­fer ­among ­patients ­with and with­out H. pylo­ri infec­tion.
Conclusion. Patients admit­ted to the Coronary Care Unit for ­acute myo­car­dial infarc­tion had a not­ably high­er prev­a­lence of H. pylo­ri infec­tion ­than the gen­er­al pop­u­la­tion. The clas­si­cal ­risk fac­tors for cor­o­nary dis­ease ­were equal­ly ­present in all ­patients ­with AMI irre­spec­tive of H. pylo­ri stat­us.

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