The association between Helicobacter pylori infection and ischemic heart disease: facts or fancy?

BACKGROUND

Helicobacter pylori infection has been associated recently with an increased risk of developing ischemic heart disease.

METHODS

We critically reviewed the literature on the association between Helicobacter and ischemic heart disease.

RESULTS

It has been suggested that a persistent low-grade inflammatory response resulting from chronic gastritis caused by H. pylori may increase the concentration of certain coagulation factors, such as fibrinogen, which are predictors of ischemic heart disease. After the appearance of the first studies indicating a moderately strong association, other researchers have investigated the potential association between these two conditions, yielding conflicting results. It must be emphasized that a relationship between fibrinogen or other hemostatic factors and H. pylori infection has been demonstrated only in cross-sectional studies, many of which included ischemic heart disease patients.

CONCLUSION

The present evidence supporting the association between H. pylori infection and ischemic heart disease is based on cross-sectional surveys, in which it is difficult to separate cause and effect. The high prevalence in the population of both H. pylori and ischemic heart disease makes it very difficult to establish a causal association. Prospective or interventional studies eventually might help to clarify the question.