High level of anti-helicobacter pylori-heat shock protein 60II3, interferon-γ, and neopterin are risk factors of cardiovascular events in acute coronary syndrome patients

• Published in: Bali medical journal Vol. 8; no. 3; pp. 834 - 840
• Main Authors: Lestari, Anak Agung Wiradewi, Wita, I Wayan, Suata, Ketut, Suastika, Ketut
• Format: Journal Article
• Language: English
• Published: 14.11.2019
• ISSN: 2089-1180; 2302-2914
• DOI: 10.15562/bmj.v8i3.1646

Background: Chronic inflammatory process that may cause acute myocardial infarction (AMI) has been known to play an important role in the pathogenesis of atherosclerosis and atheroma plaque instability. Based on inflammation process, several previous studies showed contradictory results in finding a relationship between infection H. pylori with the formation of atherosclerosis through the establishment of immunoglobulin G (IgG) anti-H. pylori-HSP60II3 (IgG anti-Hp-HSP60II3), and neopterin level due to oxidative stress. This study aims to know whether IgG anti-Hp-HSP60II3, IFN-γ and neopterin are risk factors of cardiovascular events (CVE) in patients with ACS.Methods: A prospective cohort study was conducted among 66 patients to determine the levels of IgG anti-Hp-HSP60II3, IFN-γ, and neopterin in patients with ACS as well as the levels of IgG anti-Hp-HSP60II3, IFN-γ, and neopterin. ACS patients were grouped into two groups: patients with ACS with positive prognostic factors (high levels of IgG anti-Hp-HSP60II3, IFN-γ, neopterin, and hs-CRP) and the group of patients with ACS without prognostic factor (low level of anti-IgG levels hp-HSP60II3, IFN-γ, neopterin, hs-CRP), and then were observed for 6 months while in the hospital. Data were analyzed using SPSS version 20 for Windows.Results: In observations over a period of 6 months, found as many as 15 (22.7%) patients with CVE, which consisted of 11 (16.7%) patients’ vascular death, 3 (4.5%) patients had IMA and 1 (1.5%) patients experienced recurrent cardiac ischemia from 66 patients with ACS. Mean difference between the time of occurrence CVE subjects with high and low levels of neopterin are statistically significant (P<0.05). When confounding factors such as dyslipidemia, diabetes, hypertension, obesity, smoking, and age are controlled, only neopterin levels affect the incidence CVE with the incidence rate ratio of 6.46 (95% CI: 1.45-28.74; p = 0.014) and path analysis found the effect of neopterin on CVE incidence about 49,1%, p < 0.05. Kaplan-Meier analysis gives result that the average time of CVE on a group of subjects with high levels of neopterin is shorter (129.09 days) than the group of subjects with low levels of neopterin (168.33 days) (P=0.008).Conclusion: This study found that the high level of anti-helicobacter pylori-heat shock protein 60II3, interferon-γ, and neopterin have a potential role in predicting risk factors of cardiovascular events in acute coronary syndrome patients