The Effects of Helicobacter Pylori & Cytomegalovirus Infection on the Risk of Restenosis after Percutaneous Transluminal Coronary Angioplasty

ABSTRACT

BACKGROUND: Previous studies have suggested that chronic infection may play a role in the pathophysiology of restenosis after coronary angioplasty. The purpose of our study was to investigate the relation between Helicobacter pylori(H. pylori) or cytomegalovirus (CMV) infection, and restenosis. METHODS: Fifty nine patients with coronary artery disease underwent percutaneous transluminal coronary angioplasty (PTCA) and follow-up coronary angiography (59+/-13 years, 66% male). H. pylori and CMV IgG antibody titers were measured prospectively. The minimal luminal diameter and reference diameter before and immediately after angioplasty and at follow-up were measured with quantitative analysis. RESULTS: Restenosis occurred in 23 of the 59 (39%) patients. For H. pylori, patients with high antibody titer (upper half, > or =40 U/ml) had a higher restenosis rate than patients with low antibody titer (lower half, < 40 U/ml). Seventeen of the 29 (59%) patients with high antibody titer had restenosis, while 6 of the 30 (20%) patients with low antibody titer had restenosis (p=0.002, RR=2.39, 95% CI 1.35 to 6.37). After adjustment for covariates, including age, sex, body mass index, hypercholestrolemia, hypertension, diabetes mellitus, smoking, diagnosis at admission, modality of intervention, postprocedure minimal luminal diameter, lesion length, and lesion type, H. pylori antibody titer was independently predictive of restenosis (p=0.005). For CMV, patients with high antibody titer did not have a higher restenosis rate than patients with low antibody titer. CONCLUSION: High antibody titer against H. pylori may be an independent risk factor of restenosis after PTCA. However, there was no association between CMV antibody titer and the risk of restenosis.