Association of Helicobacter pylori infection with cardiac syndrome X

Eskandarian R, Malek M, Mousavi SH, Babaei M
Correspondence: Dr Rahimeh Eskandarian, malekmoj@yahoo.com

ABSTRACT
Introduction Cardiac syndrome X (CSX) includes chest pain, positive exercise stress test and/or radionuclide test for ischaemia and normal coronary angiography. There is no obvious aetiology for this syndrome. Some mechanisms such as endothelial dysfunction and oestrogen deficiency have been invoked. In this study, we surveyed the association of Helicobacter pylori (HP) infection with cardiac syndrome X.
Methods HP infection was detected by urea breath test (UBT) in patients with cardiac syndrome X, and compared with a sex- and age-matched control group. Patients with dyspepsia and coronary spasm were excluded. Statistical analysis was carried out using chi-square test.
Results 40 patients (29 females and 11 males) with cardiac syndrome X aged between 30 and 65 years (mean 45.51 +/- 5.03 years) were compared with a control group (28 females and 12 males) aged between 31 and 64 years old (mean 44.93 +/- 5.16 years). 95 percent of patients were HP infected, while only 47.5 percent of members of the control group were infected (p-value is less than 0.001).
Conclusion Considering the high prevalence of HP infection in patients with CSX in our sample and probable causative effect of chronic infection in vascular diseases, we believe that there is a probable role for HP infection in the pathogenesis of CSX.

Keywords: cardiac syndrome X, chest pain, coronary artery, Helicobacter pylori, vascular diseases
Singapore Med J 2006; 47(8): 704-706