Fialho A, et al. - Researchers planned this study to assess the frequency and risk factors for angiography-confirmed coronary artery disease (CAD) in patients with or without small intestinal bacterial overgrowth (SIBO). In this study from a single tertiary center, a correlation was demonstrated, of SIBO with CAD and with the number of coronary arteries involved. To confirm the association of SIBO with CAD, further studies were required. Patients with SIBO could benefit from assessment for CAD in the presence of risk factors.

Methods

• The researchers evaluated 1,059 patients tested for SIBO using the glucose hydrogen/methane breath test from 2006 to 2014.
• They included 160 patients in the study who had coronary artery angiography.
• They compared SIBO-positive patients to SIBO-negative patients.
• They examined demographic, clinical, and laboratory variables and the presence of CAD on coronary angiography.

Results

• A higher frequency of CAD (78.9 vs. 38.6%, p < 0.001), diabetes mellitus (40.0 vs 22.9%, p=0.016), chronic kidney disease (26.7 vs 12.9%, p=0.025), use of angiotensin conversion enzyme inhibitor/blocker (45.5 vs 32.9%, p=0.008), and statins (75.6 vs 61.4%, p=0.004) was observed in patients with SIBO.
• An increased number of coronary arteries affected was found in patients with SIBO compared to SIBO-negative patients (1-vessel disease 67.2 vs 32.8%, p < 0.001; 2-vessel disease 85.7 vs 14.3%, p < 0.001; and 3-vessel disease 82.4 vs 17.6%, p < 0.001, respectively).
• For CAD, SIBO remained an independent risk factor (odds ratio 7.18, 95% confidence interval 3.09-16.67; p < 0.001) in the stepwise multivariate logistic regression analysis.