Cardiovascular Unit, John Hunter Hospital, University of Newcastle, Newcastle, New South Wales, Australia.
Intern Med J. 2012 Mar;42(3):289-93. doi: 10.1111/j.1445-5994.2010.02260.x. Epub 2010 May 11.
The adverse effect of haemorrhagic complications after percutaneous coronary intervention (PCI) on outcome is well established with Helicobacter pylori infection known to be an important precipitant of peptic ulcer disease in patients receiving non-steroidal anti-inflammatory drug therapy. The prevalence of H. pylori positivity in patients undergoing PCI and receiving subsequent antiplatelet therapy is unknown.
We sought to determine the prevalence and features associated with H. pylori positivity in patients undergoing PCI.
All patients undergoing PCI between August 2008 and April 2009 were identified and assessed for H. pylori positivity with serological status determined by using a commercially supplied enzyme-linked immunosorbent assay.
A total of 245 patients undergoing PCI during the study period had samples obtained for H. pylori serology. Of these, 91 were positive for H. pylori serology (37%) and 148 were negative (60%) with six samples being equivocal (3%). Of those patients positive for H. pylori, 75% were on agents at admission known to promote or precipitate gastrointestinal haemorrhage. Patients positive for H. pylori tended to be older, with increased creatinine and more likely to be receiving proton pump inhibitor therapy.
In an unselected cohort of patients undergoing PCI in a single centre, we detected a prevalence of H. pylori positivity in 37% of patients; this denotes a potentially treatable precipitant of haemorrhage in a considerable portion of patients receiving dual antiplatelet therapy after PCI. Further prospective study is required to determine if the presence of H. pylori positivity is associated with adverse events in terms of gastrointestinal and cardiac outcomes.
经皮冠状动脉介入治疗（PCI）后出血并发症对预后的不良影响已得到充分证实，已知幽门螺杆菌（H. pylori）感染是接受非甾体抗炎药治疗的患者发生消化性溃疡病的重要诱发因素。接受 PCI 并随后接受抗血小板治疗的患者中 H. pylori 阳性的患病率尚不清楚。
我们旨在确定接受 PCI 的患者中 H. pylori 阳性的患病率及其相关特征。
确定 2008 年 8 月至 2009 年 4 月期间接受 PCI 的所有患者，并使用商业供应的酶联免疫吸附试验通过血清学状态评估 H. pylori 阳性情况。
在研究期间接受 PCI 的 245 例患者中有样本用于 H. pylori 血清学检查。其中，91 例 H. pylori 血清学阳性（37%），148 例 H. pylori 血清学阴性（60%），6 例结果不确定（3%）。H. pylori 阳性患者中，75%的患者入院时使用已知可促进或诱发胃肠道出血的药物。H. pylori 阳性患者年龄较大，肌酐升高，更有可能接受质子泵抑制剂治疗。
在单中心的一组未经选择的接受 PCI 的患者中，我们发现 37%的患者存在 H. pylori 阳性，这意味着在相当一部分接受 PCI 后接受双联抗血小板治疗的患者中，存在潜在可治疗的出血诱发因素。需要进一步前瞻性研究来确定 H. pylori 阳性是否与胃肠道和心脏结局的不良事件相关。
