Takeaway
- This meta-analysis suggests that Helicobacter pylori (H pylori) infection increase the risk for acute coronary syndrome (ACS), especially in developing countries.
Why this matters
- H pylori can be easily screened and treated with a wide range of drugs.
- Findings warrant further studies to determine whether the treatment of H pylori is an effective way to reduce the risk for ACS.
Study design
- 44 studies including 15,833 participants (7522 cases and 8311 controls) met eligibility criteria after a search across Medica Database, PubMed and other databases.
- Funding: None disclosed.
Key results
- H pylori infection was associated with an increased risk for ACS (OR, 2.03; 95% CI, 1.66-2.47; I2=84.9%).
- In the subgroup analysis:
- The risk for ACS was higher with H pylori infection in:
- high-quality (OR, 2.29; 95% CI, 1.76-2.99; I2=89.6%) and low-quality (OR, 1.70; 95% CI, 1.29-2.24; I2=66.3%) studies.
- Europe (OR, 1.75; 95% CI, 1.40-2.19; I2=77.3%),
- Asia (OR, 2.45; 95% CI, 1.71-3.51; I2=88.9%) and
- America (OR, 1.46; 95% CI, 1.02-2.10).
- In the subgroup analysis:
- H pylori infection was associated with an increased risk for ACS in developing (OR, 2.58; 95% CI, 1.78-3.73; I2=84.9%) vs developed (OR, 1.69; 95% CI, 1.40-2.05; I2=76.3%) countries.
- A strong association was observed between H pylori infection and the risk for ACS in enzyme-linked immunosorbent assay subgroup (OR, 1.95; 95% CI,1.60-2.37).
- H pylori infection with cytotoxin-associated antigen A was linked to increased risk for ACS (OR, 2.39; 95% CI, 1.21-4.74).
Limitations
- Heterogeneity among studies.
References
References