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心房颤动与幽门螺杆菌的关系。

Association between atrial fibrillation and Helicobacter pylori.

机构信息

Department of Cardiothoracic Surgery, Cardiovascular Research Institute Maastricht -CARIM, Maastricht University Medical Centre, Universiteitssingel 50, 6229 ER, Maastricht, The Netherlands.

出版信息

Clin Res Cardiol. 2019 Jul;108(7):730-740. doi: 10.1007/s00392-019-01418-w. Epub 2019 Feb 8.

Abstract

The connection between atrial fibrillation (AF) and H. pylori (HP) infection is still matter of debate. We performed a systematic review and metanalysis of studies reporting the association between AF and HF. A systematic review of all available reports in literature of the incidence of HP infection in AF and comparing this incidence with subjects without AF were analysed. Risk ratio and 95% confidence interval (CI) and risk difference with standard error (SE) were the main statistics indexes. Six retrospective studies including a total of 2921 were included at the end of the selection process. Nine hundred-fifty-six patients (32.7%) were in AF, whereas 1965 (67.3%) were in normal sinus rhythm (NSR). Overall, 335 of 956 patients with AF were HP positive (35%), whereas 621 were HP negative (65%). In addition, 643 of 1965 NSR patients (32.7%) were HP positive while 1,322 were negative (67.3%; Chi-square 2.15, p = 0.21). The Cumulative Risk Ratio for AF patients for developing an HP infection was 1.19 (95% CI 1.08-1.41). In addition, a small difference risk towards AF was found (0.11 [SE = 0.04]). Moreover, neither RR nor risk difference were influenced by the geographic area at meta-regression analysis. Finally, there was a weak correlation between AF and HP (coefficient = 0.04 [95% CI -0.01-0.08]). We failed to find any significant correlation between H. pylori infection and AF and, based on our data, it seems unlikely than HP can be considered a risk factor for AF. Further larger research is warranted.

摘要

心房颤动 (AF) 与 H. pylori (HP) 感染之间的联系仍存在争议。我们对报道 AF 与 HF 之间相关性的研究进行了系统评价和荟萃分析。分析了文献中所有关于 AF 中 HP 感染发生率的可用报告,并将该发生率与无 AF 的受试者进行比较。主要统计指标为风险比和 95%置信区间 (CI) 以及标准误 (SE) 的风险差异。选择过程结束后,共纳入 6 项回顾性研究,共 2921 例。956 例患者 (32.7%) 为 AF,1965 例为窦性心律正常 (NSR) (67.3%)。总体而言,956 例 AF 患者中 335 例 (35%) HP 阳性,621 例 HP 阴性 (65%)。此外,1965 例 NSR 患者中 643 例 (32.7%) HP 阳性,1322 例 HP 阴性 (67.3%;卡方 2.15,p=0.21)。AF 患者发生 HP 感染的累积风险比为 1.19 (95% CI 1.08-1.41)。此外,发现 AF 风险略有差异 (0.11 [SE=0.04])。此外,在荟萃回归分析中,RR 和风险差异均不受地理区域的影响。最后,AF 与 HP 之间存在弱相关性 (系数=0.04 [95% CI -0.01-0.08])。我们未能发现 HP 感染与 AF 之间存在任何显著相关性,根据我们的数据,HP 不太可能被认为是 AF 的危险因素。需要进一步进行更大规模的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d21/6584225/841d8152c22d/392_2019_1418_Fig1_HTML.jpg

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