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A Prospective Study of Helicobacter pylori Seropositivity and the Risk for Future Myocardial Infarction among Socioeconomically Similar U.S. Men

Paul M. Ridker, MD, MPH; John Danesh, MBChB; Linda Youngman, PhD; Rory Collins, MBBS; Meir J. Stampfer, MD; Richard Peto, FRS; and Charles H. Hennekens, MD
[+] Article and Author Information

From the Center for Cardiovascular Disease Prevention, the Leducq Center for Molecular and Genetic Epidemiology of Cardiovascular Diseases, and the Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; the University of Miami, Miami, Florida; and the Clinical Trials Service Unit, Radcliffe Infirmary, Oxford, United Kingdom.


Grant Support: In part by a grant from the National Heart, Lung, and Blood Institute (HL58755). Dr. Ridker is additionally supported by an Established Investigator Award from the American Heart Association and by a Distinguished Clinical Scientist Award from the Doris Duke Charitable Foundation.

Requests for Single Reprints: Paul M. Ridker, MD, Center for Cardiovascular Disease Prevention, Brigham and Women's Hospital, 900 Commonwealth Avenue East, Boston, MA 02215; e-mail, pridker@partners.org.

Current Author Addresses: Drs. Ridker and Stampfer: Center for Cardiovascular Disease Prevention, Brigham and Women's Hospital, 900 Commonwealth Avenue East, Boston, MA 02215.

Drs. Danesh, Youngman, Collins, and Peto: Clinical Trials Service Unit, Oxford University, Oxford OX2 6HE, United Kingdom.

Dr. Hennekens: 2800 South Ocean Boulevard, Penthouse A, Boca Raton, FL 33432.

Author Contributions: Conception and design: P.M. Ridker, M.J. Stampfer, C.H. Hennekens.

Analysis and interpretation of the data: P.M. Ridker, J. Danesh, L. Youngman, R. Collins, M.J. Stampfer, R. Peto, C.H. Hennekens.

Drafting of the article: P.M. Ridker.

Critical revision of the article for important intellectual content: P.M. Ridker, J. Danesh, L. Youngman, R. Collins, M.J. Stampfer, R. Peto, C.H. Hennekens.

Final approval of the article: P.M. Ridker, J. Danesh, L. Youngman, R. Collins, M.J. Stampfer, C.H. Hennekens.

Provision of study materials or patients: P.M. Ridker, M.J. Stampfer, C.H. Hennekens.

Statistical expertise: P.M. Ridker, R. Collins, R. Peto.

Obtaining of funding: P.M. Ridker.

Administrative, technical, or logistic support: L. Youngman.

Collection and assembly of data: P.M. Ridker.


Ann Intern Med. 2001;135(3):184-188. doi:10.7326/0003-4819-135-3-200108070-00010
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Background: The role of Helicobacter pylori as a determinant of cardiovascular disease is controversial.

Objective: To determine whether previous exposure to H. pylori is associated with an increased risk for myocardial infarction.

Design: Prospective case–control study.

Setting: Physicians' Health Study.

Participants: Initially healthy U.S. men.

Measurements: Titers of IgG antibody against H. pylori and several inflammatory markers were measured in baseline blood samples obtained from 445 men who subsequently had a myocardial infarction (case-patients) and 445 men matched for age and smoking status who remained free of vascular disease (controls) during a mean follow-up of 8.9 years.

Results: Baseline seropositivity was similar among case-patients and controls (43.4% vs. 44.3%; rate ratio, 0.96 [95% CI, 0.7 to 1.3]). Minimal evidence of association was found between magnitude of seropositivity and subsequent risk and between seropositivity and levels of the inflammatory biomarkers.

Conclusion: In a socioeconomically homogeneous population, we found limited evidence of association between H. pylori exposure and risk for future myocardial infarction.

Figures

Grahic Jump Location
Figure.
Odds ratios in prospective studies ofHelicobacter pyloriseropositivity and death from coronary heart disease or nonfatal myocardial infarction.

Black squares indicate the odds ratio in each study; the square size is proportional to the number of cases, and the solid horizontal line represents the 99% CI. In each of the prospective studies shown in the figure, the investigators adjusted for the possible confounding variables of age, sex, and smoking status (++). Some studies also adjusted for other standard vascular risk factors (+++) and for information (or matching) on markers of socioeconomic status (++++). The studies are ordered according to degree of adjustment and sample size; odds ratios are plotted on a logarithmic scale.

Grahic Jump Location

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Summary for Patients

Helicobacter pylori Infection and the Risk for Heart Attacks in Men

The summary below is from the full report titled “A Prospective Study of Helicobacter pylori Seropositivity and the Risk for Future Myocardial Infarction among Socioeconomically Similar U.S. Men.” It is in the 7 August 2001 issue of Annals of Internal Medicine (volume 135, pages 184-188). The authors are PM Ridker, J Danesh, L Youngman, R Collins, MJ Stampfer, R Peto, and CH Hennekens.

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