H pylori infection tied to higher risk for acute coronary syndrome

  • Fang Y & al.
  • Medicine (Baltimore)
  • 1 Dec 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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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).
  • 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.