Objective: To test the hypothesis that infection with virulent cytotoxin-associated gene-A (CagA)-bearing Helicobacter pylori strains influences the atherosclerotic process and the clinical course in atherosclerotic stroke patients. Methods: ELISA was used to assess the seroprevalence of infection by H. pylori and CagA-positive strains in 185 patients. Intima-media thickness (IMT) was determined by Doppler ultrasound. Baseline, 1-week, and 1-month NIH Stroke Scale (NIHSS) scores were used to evaluate the short-term clinical course. Results: H. pylori infection was found in 79% of patients; 58% of these tested positive for CagA. IMT was higher among CagA-positive patients than among CagA-negative ones (1.13 +/- 0.26 mm vs 0.97 +/- 0.15 mm; univariate analysis, p = 0.0001; multivariate analysis, odds ratio [ OR], 2.36; 95% CI, 1.57 to 3.54; p = 0.0001) or H. pylori-negative ones ( 1.01 +/- 0.17 mm; univariate analysis, p = 0.007; multivariate analysis, OR, 1.90; 95% CI, 1.22 to 2.97; p = 0.005). CagA-positive patients had poorer initial outcomes based on serial measurements of the NIHSS score ( repeated measures analysis of variance, p < 0.0001). No significant difference in IMT and NIHSS score was found between H. pylori-positive and H. pylori-negative patients. Conclusions: Infection with cytotoxin-associated gene-A-positive Helicobacter pylori strains in atherosclerotic stroke patients is associated with greater intima-media thickness and poorer short-term outcome compared with cytotoxin-associated gene-A-negative patients.

Diomedi, M., Pietroiusti, A., Silvestrini, M., Rizzato, B., Cupini, L.M., Ferrante, F., et al. (2004). CagA-positive Helicobacter pylori strains may influence the natural history of atherosclerotic stroke. NEUROLOGY, 63(5), 800-804.

CagA-positive Helicobacter pylori strains may influence the natural history of atherosclerotic stroke

DIOMEDI, MARINA;PIETROIUSTI, ANTONIO;SILVESTRINI, MAURO;MAGRINI, ANDREA;BERGAMASCHI, ANTONIO;GALANTE, ALBERTO;BERNARDI, GIORGIO
2004-09

Abstract

Objective: To test the hypothesis that infection with virulent cytotoxin-associated gene-A (CagA)-bearing Helicobacter pylori strains influences the atherosclerotic process and the clinical course in atherosclerotic stroke patients. Methods: ELISA was used to assess the seroprevalence of infection by H. pylori and CagA-positive strains in 185 patients. Intima-media thickness (IMT) was determined by Doppler ultrasound. Baseline, 1-week, and 1-month NIH Stroke Scale (NIHSS) scores were used to evaluate the short-term clinical course. Results: H. pylori infection was found in 79% of patients; 58% of these tested positive for CagA. IMT was higher among CagA-positive patients than among CagA-negative ones (1.13 +/- 0.26 mm vs 0.97 +/- 0.15 mm; univariate analysis, p = 0.0001; multivariate analysis, odds ratio [ OR], 2.36; 95% CI, 1.57 to 3.54; p = 0.0001) or H. pylori-negative ones ( 1.01 +/- 0.17 mm; univariate analysis, p = 0.007; multivariate analysis, OR, 1.90; 95% CI, 1.22 to 2.97; p = 0.005). CagA-positive patients had poorer initial outcomes based on serial measurements of the NIHSS score ( repeated measures analysis of variance, p < 0.0001). No significant difference in IMT and NIHSS score was found between H. pylori-positive and H. pylori-negative patients. Conclusions: Infection with cytotoxin-associated gene-A-positive Helicobacter pylori strains in atherosclerotic stroke patients is associated with greater intima-media thickness and poorer short-term outcome compared with cytotoxin-associated gene-A-negative patients.
Pubblicato
Rilevanza internazionale
Articolo
Sì, ma tipo non specificato
Settore MED/26 - Neurologia
Settore MED/44 - Medicina del Lavoro
English
Con Impact Factor ISI
CagA protein; adult; aged; artery intima proliferation; article; atherosclerosis; bacterial strain; disease course; Doppler echography; enzyme linked immunosorbent assay; female; Helicobacter infection; Helicobacter pylori; human; major clinical study; male; priority journal; stroke; Aged; Aged, 80 and over; Antibodies, Bacterial; Antigens, Bacterial; Bacterial Proteins; Brain Ischemia; C-Reactive Protein; Carotid Arteries; Carotid Artery Diseases; Comorbidity; Female; Helicobacter Infections; Helicobacter pylori; Humans; Hyperglycemia; Hyperlipidemias; Hypertension; Immunoglobulin G; Male; Middle Aged; Obesity; Seroepidemiologic Studies; Severity of Illness Index; Tunica Intima; Tunica Media; Virulence
WOS:000223830900008
Diomedi, M., Pietroiusti, A., Silvestrini, M., Rizzato, B., Cupini, L.M., Ferrante, F., et al. (2004). CagA-positive Helicobacter pylori strains may influence the natural history of atherosclerotic stroke. NEUROLOGY, 63(5), 800-804.
Diomedi, M; Pietroiusti, A; Silvestrini, M; Rizzato, B; Cupini, L; Ferrante, F; Magrini, A; Bergamaschi, A; Galante, A; Bernardi, G
Articolo su rivista
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2108/30961
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 45
  • ???jsp.display-item.citation.isi??? 41
social impact