Koroner Aterosklerozda CagA Pozitif Helicobacter pylori Enfeksiyonu: Lenfosit Sayısının Ortalama Trombosit Hacmine Oranının Tanısal Değeri

Abstract

Aim: Potent combined and long-term antithrombotic therapies that predispose to gastric injury are the mainstay of treatment in acute coronary syndromes (ACS). Severe chronic gastric mucosal inflammation due to the Helicobacter Pylori (H. pylori) infection was shown to be associated with higher peripheral blood lymphocytes and lower blood mean platelet volume (MPV) levels. We aimed to investigate the discriminative usefulness of blood lymphocyte to MPV ratio as a simple premise marker for CagA positive H. Pylori infection before the required advanced diagnostic tests in patients with coronary arterial disease (CAD). Materials and Methods: A total of 293 patients’ who had undergone elective and urgent coronary angiography due to CAD were included in the study. Serologic H. pylori infection status and hematological parameters were determined. Two groups were compared according to CagA serology status. Confounding factors were adjusted by propensity score matching and multivariate logistic regression analysis. Results: Rates of ACS, male gender, diabetes mellitus, family history of CAD, current smoking and lymphocyte to MPV ratio were higher in seropositive patients according to seronegative patients (p < 0.05). The ROC curve analysis showed that the lymphocyte to MPV ratio at a cut-off point of 165 had 71% sensitivity and 60% specificity for discriminating patients with positive H. pylori serology (AUC = 0.71, p < 0.0001). Lymphocyte to MPV ratio was independently associated with positive H. Pylori serology. Conclusion: Lymphocyte to MPV ratio can be helpful for discriminating CagA positive H pylori infected CAD patients requiring advanced confirmatory tests.