The prevalence of Helicobacter pylori infection in elderly patients with coronary atherosclerotic heart disease and the correlation between their serum antibody types and the degree of coronary artery disease

Zhang Chen; Xu Yingzhi; Li Ying

doi:10.3760/j.issn.1673-4777.2025.07.001

Abstract：Objective To investigate the prevalence of Helicobacter pylori(Hp)infection in elderly patients with coronary atherosclerotic heart disease(CHD)and the correlation between their serum antibody types and the degree of coronary artery disease.Methods A total of 217 patients with CHD who were admitted to Western Theater General Hospital from April 2021 to June 2023 were selected as the research objects.The patients were divided into mild group(72 cases),moderate group(74 cases)and severe group(71 cases)according to the Gensini score tertiles.The general data of patients in each group were collected,the serum biochemical indexes,inflammatory factor indexes[high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)]and Hp serum antibody classification of patients in each group were detected,and the plaque status of patients was evaluated.The related factors affecting the severity of coronary artery disease in elderly patients with CHD were analyzed.The correlation between Hp subtypes and levels of inflammatory factors was analyzed.Results There were significant differences in the proportion of Hp infection,high-risk plaque,and multi-vessel coronary artery disease among the three groups(all P＜0.05).The detection rates of cytotoxin-associated gene A product(CagA)/toxic vacuolated cytotoxin(VacA)in patients with multi-vessel lesions and high-risk plaque were higher than those in patients with single-vessel lesions and non-high-risk plaque[40.7％(35/86)vs 19.8％(26/131),48.5％(32/66)vs 19.2％(29/151)],and the detection rate of CagA/VacA increased in the mild group,moderate group and severe group[8.3％(6/72),28.4％(21/74)and 47.9％(34/71)](all P＜0.05).The levels of total cholesterol,triglyceride,low-density lipoprotein cholesterol(LDL-C),hs-CRP,IL-6 and TNF-α in the moderate and severe groups were higher than those in the mild group,and those in the severe group were higher than those in the moderate group(all P＜0.05).Ordinal Logistic regression analysis showed that the levels of CagA/VacA subtype,total cholesterol,triglyceride,LDL-C,hs-CRP,IL-6 and TNF-α were all the independent risk factors for the severity of coronary artery disease in elderly patients with CHD(all P＜0.05).The levels of hs-CRP,IL-6 and TNF-α in patients with CagA/VacA infection were higher than those with UreA/UreB infection in the mild,moderate and severe groups(all P＜0.05).The levels of hs-CRP,IL-6 and TNF-αwere positively correlated with the CagA/VacA subtype(all P＜0.05),and negatively correlated with the UreA/UreB subtype(all P＜0.05).Conclusions Hp infection is closely related to the degree of coronary artery lesions in elderly CHD patients.The degree of coronary artery lesions is more serious in elderly CHD patients with Hp positive and CagA/VacA antibody type.