Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China.
Department of Scientific Research and Education, Shunde Hospital, Southern Medical University, Foshan, China.
Helicobacter. 2023 Jun;28(3):e12967. doi: 10.1111/hel.12967. Epub 2023 Mar 28.
Whether Helicobacter pylori (H. pylori) infection is associated with an increased risk of cardiovascular disease (CVD) remains controversial. This study aimed to investigate the association between H. pylori infection and the risk of CVD.
Potentially related studies were searched in the electronic databases, including PubMed, EMBASE and Cochrane Library, from inception to 31 August 2022. Observational cohort studies that reported the multivariable-adjusted relative risks (RRs) for composite CVD, CHD, stroke, or all-cause mortality associated with H. pylori infection were included in the meta-analysis, using random-effects models.
Forty-one cohort studies with 230,288 participants were included. After a median follow-up duration of 6.3 years, H. pylori infection was associated with a mildly increased risk of composite CVD (RR 1.10, 95% CI 1.03, 1.18) and coronary heart disease (RR 1.10, 95% CI 1.02, 1.18) compared with those without H. pylori infection. No significant association was observed between H. pylori infection and risk of stroke (RR 1.08, 95% CI 0.94, 1.23) or all-cause mortality (RR 1.02, 95% CI 0.90, 1.16). Compared with cytotoxin-associated gene-A (CagA) negative H. pylori infection, the risk of CVD was significantly increased in patients with CagA positive H. pylori infection (RR 1.58, 95% CI 1.03, 2.41).
Helicobacter pylori infection is associated with a mildly increased risk of CVD. It may be of great public health and clinical significance to screen H. pylori infection in patients with a high risk of CVD.
幽门螺杆菌（H. pylori）感染是否与心血管疾病（CVD）风险增加相关仍存在争议。本研究旨在探讨 H. pylori 感染与 CVD 风险之间的关系。
在电子数据库中检索了可能相关的研究，包括 PubMed、EMBASE 和 Cochrane Library，检索时间截至 2022 年 8 月 31 日。纳入了报告 H. pylori 感染与复合 CVD、冠心病、中风或全因死亡率的多变量调整相对风险（RR）的观察性队列研究，并使用随机效应模型进行荟萃分析。
共纳入 41 项队列研究，包含 230288 名参与者。经过 6.3 年的中位随访时间，与未感染 H. pylori 的患者相比，H. pylori 感染与复合 CVD（RR 1.10，95%CI 1.03，1.18）和冠心病（RR 1.10，95%CI 1.02，1.18）的风险略有增加。但未发现 H. pylori 感染与中风（RR 1.08，95%CI 0.94，1.23）或全因死亡率（RR 1.02，95%CI 0.90，1.16）之间存在显著关联。与细胞毒素相关基因 A（CagA）阴性 H. pylori 感染相比，CagA 阳性 H. pylori 感染患者的 CVD 风险显著增加（RR 1.58，95%CI 1.03，2.41）。
H. pylori 感染与 CVD 风险轻度增加相关。对 CVD 高危患者进行 H. pylori 感染筛查可能具有重要的公共卫生和临床意义。
