Helicobacter pylori heat shock protein 60 and risk of coronary heart disease: a case control study with focus on markers of systemic inflammation and lipids

Aim: it has been suggested that antibodies against heat shock proteins seem to be involved in the pathogenesis of coronary heart disease (CHD). We conducted a case-control study to investigate whether antibodies against Helicobacter pylori heat shock protein 60 (hsp60) are associated with CHD, and focused specifically on markers of systemic inflammation and lipids. Methods: all patients of German nationality aged 40–68 years who underwent coronary angiography at the University of Ulm between October 1996 and November 1997 and who had at least one coronary stenosis greater than 50% were included in the study. Controls were sampled from voluntary blood donors and were matched for sex and age. H. pylori hsp60 was assessed by Western blot (H. pylori Westernblot, AID Co., Strassberg, Germany). In addition, C-reactive protein, fibrinogen, plasma viscosity, leukocytes, HDL-cholesterol and Lp(a) were determined. Results: overall, 312 patients and 479 controls were enrolled in the study (response in patients 78%, in controls 84%). Whereas 25.0 and 22.4% of the cases showed a hsp60 extinction of 100 or 20–99% (according to the reference blot), respectively, only 21.3 and 14.8% of the controls did so (P=0.004). The age and sex adjusted odds ratio (OR) for CHD was 1.53 (95% confidence interval (CI) 1.14–2.06) given an extinction of 20–100% compared with an extinction of 0–19%. The OR for CHD decreased to 1.28 (95% CI 0.90–1.81) after further adjustment for other covariates. With exception of HDL-cholesterol (lowest in subjects with the highest hsp60 extinction) none of the investigated inflammatory markers was associated with the hsp60 distribution. Conclusion: a high H. pylori hsp60 extinction seems not to be an independent risk factor for CHD in this population.