Review
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Mar 26, 2015; 7(3): 134-143
Published online Mar 26, 2015. doi: 10.4330/wjc.v7.i3.134
Role of Helicobacter pylori infection in pathogenesis of atherosclerosis
Rajesh Vijayvergiya, Ramalingam Vadivelu
Rajesh Vijayvergiya, Ramalingam Vadivelu, Department of Cardiology, Advanced Cardiac Centre, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
Author contributions: Both the authors have contributed equally to this review article; Vijayvergiya R has done literature search, critical review and analysis of the literature and a revision of the manuscript; and Vadivelu R has performed literature search and review, articles extraction, writing of first draft of the manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Rajesh Vijayvergiya, MD, DM, FSCAI, FISES, FACC, Additional Professor, Department of Cardiology, Advanced Cardiac Centre, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India. rajeshvijay999@hotmail.com
Telephone: +91-172-2756518 Fax: +91-172-2744401
Received: June 24, 2014
Peer-review started: June 24, 2014
First decision: June 24, 2014
Revised: October 4, 2014
Accepted: November 27, 2014
Article in press: December 1, 2014
Published online: March 26, 2015
Abstract

Though a century old hypothesis, infection as a cause for atherosclerosis is still a debatable issue. Epidemiological and clinical studies had shown a possible association but inhomogeneity in the study population and study methods along with potential confounders have yielded conflicting results. Infection triggers a chronic inflammatory state which along with other mechanisms such as dyslipidemia, hyper-homocysteinemia, hypercoagulability, impaired glucose metabolism and endothelial dysfunction, contribute in pathogenesis of atherosclerosis. Studies have shown a positive relations between Cytotoxic associated gene-A positive strains of Helicobacter pylori and vascular diseases such as coronary artery disease and stroke. Infection mediated genetic modulation is a new emerging theory in this regard. Further large scale studies on infection and atherosclerosis focusing on multiple pathogenetic mechanisms may help in refining our knowledge in this aspect.

Keywords: Atherosclerosis, Coronary artery disease, Helicobacter pylori, Infection, Stroke

Core tip: Though a century old hypothesis, infection as a cause of atherosclerosis is still a debatable issue. Clinical and epidemiological studies had shown a possible association, however in-homogeneity in the study population and methodology has yielded conflicting results. We performed a literature search on MEDLINE electronic database using keywords such as Helicobacter pylori (H. pylori), infection, atherosclerosis, coronary artery disease, myocardial infarction, stroke, cerebro-vascular disease and peripheral arterial disease using MeSH terms, to review this subject. The association between H. pylori and atherosclerosis is not strong and a causal role is not yet established. Large scale studies on infection and atherosclerosis focusing on multiple pathogenetic mechanisms may help in refining our knowledge in this aspect.