幽门螺杆菌血清流行率与心肌梗死发病率——一项基于瑞典人群的巢式病例对照研究。

Seroprevalence of Helicobacter pylori and incident myocardial infarction - A population-based Swedish nested case-control study.

作者信息

Sundqvist Martin O, Svensson Per, Söderberg Stefan, Bergdahl Ingvar A, Wennberg Patrik, Tornvall Per, Andersson Jonas S O, Hofmann Robin

机构信息

Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Department of Cardiology, Södersjukhuset, Stockholm, Sweden.

出版信息

Int J Cardiol. 2025 Feb 15;421:132917. doi: 10.1016/j.ijcard.2024.132917. Epub 2024 Dec 16.

DOI:10.1016/j.ijcard.2024.132917

PMID:39689819

Abstract

AIMS

Helicobacter pylori (H. pylori) and its cytotoxin-associated gene A (CagA) have been associated with myocardial infarction (MI), but existing data are conflicting possibly due to limitations in study designs and lack of data on important confounders. The aim of this study was to determine whether H. pylori or CagA seropositivity is associated with incident MI, including MI phenotypes, and to describe temporal trends.

METHODS

We used the Northern Sweden Health and Disease study, a prospective biobank with data from residents enrolled in a population-based cohort from health examinations between 1986 and 2006. A total of 826 first time MI cases with available blood samples from their index health examination were identified up to 2006. Each case was 1:2 matched with controls by age, sex, sample date and geographical area. Blood samples were analysed using ELISA to determine seroprevalence of H. pylori and CagA, which were then used to study the association with incident MI.

RESULTS

The median age at baseline was 50 years, and 71% of participants were male. Seroprevalence of H. pylori and CagA was 46.5% and 32.1% in cases, respectively, compared to 43.7% and 30.6% in controls. Overall, H. pylori prevalence decreased over the study period. After multivariable adjustments, no significant association was observed between H. pylori seropositivity and incident MI (odds ratio: 1.15, 95% CI 0.94-1.42) nor between CagA-positive H. pylori and incident MI.

CONCLUSION

In a Swedish population-based cohort, no significant association was observed between H. pylori or CagA seropositivity and incidence of MI.

摘要

目的

幽门螺杆菌（H. pylori）及其细胞毒素相关基因A（CagA）与心肌梗死（MI）有关，但现有数据相互矛盾，这可能是由于研究设计的局限性以及缺乏关于重要混杂因素的数据。本研究的目的是确定幽门螺杆菌或CagA血清阳性是否与新发心肌梗死相关，包括心肌梗死的表型，并描述其时间趋势。

方法

我们使用了瑞典北部健康与疾病研究，这是一个前瞻性生物样本库，包含1986年至2006年间参加基于人群队列健康检查的居民的数据。截至2006年，共确定了826例首次心肌梗死病例，这些病例在其首次健康检查时均有可用的血液样本。每个病例按年龄、性别、样本日期和地理区域与对照组进行1:2匹配。使用酶联免疫吸附测定法（ELISA）分析血液样本，以确定幽门螺杆菌和CagA的血清阳性率，然后用于研究与新发心肌梗死的关联。

结果

基线时的中位年龄为50岁，71%的参与者为男性。病例组中幽门螺杆菌和CagA的血清阳性率分别为46.5%和32.1%，而对照组分别为43.7%和30.6%。总体而言，在研究期间幽门螺杆菌的患病率有所下降。经过多变量调整后，未观察到幽门螺杆菌血清阳性与新发心肌梗死之间存在显著关联（优势比：1.15，95%置信区间0.94 - 1.42），CagA阳性的幽门螺杆菌与新发心肌梗死之间也无显著关联。