Impact of iron status and inflammatory indices on atherosclerotic burden of patients with helicobacter pylori infection and coronary arterial disease

Objective: Both inflammation and iron deficiency are suggested to be associated with coronary arterial diseases (CAD) and H. Pylori infection. The explanatory interaction depending on serum iron status and inflammatory biomarkers for the extent of atherosclerosis in H. Pylori infection is obscure. Therefore, we aimed to analyze the impact of iron Status and inflammatory indices on atherosclerotic burden of seropositive CAD patients with CagA (cytotoxin-associated gene A) strains of H. Pylori. Materials and Methods: This was an observational study of patients' undergone elective and urgent coronary angiography due to CAD. Serologic H. pylori infection status and iron status was determined in all of 293 subjects. Further seropositive patients were divided into groups to evaluate the extent of coronary atherosclerosis according to Syntax scoring system. Propensity score matching and covariate- adjusted multivariate logistic regression were used to adjust for baseline differences between study groups. Results: The odds ratio of positive serology for the presence of iron deficiency and acute coronary syndromes were 2.5 (95% CI (1.1-5.4); p = 0.02) and 3.0 (95% CI (1.3-7.0); p = 0.007) respectively. After controlling for diabetes mellitus, smoking, MPV, RDW and haemoglobin levels; Tsat ≤ 24.5 remained negatively associated with advanced atherosclerosis (OR:9.9, 95% CI (4.1-24.3); p < 0.0001). In our matched sample, multivariable linear regression analysis showed that association of syntax score with Tsat was independent of hs-CRP (p=0.001). Conclusions: Irrespective of inflammatory status, transferrin saturation can be the decisive mirror indicator of advanced atherosclerosis in seropositive CAD patients with CagA strains of H. Pylori.