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

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 (÷2 =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.