Association between Helicobacter Pylori infection and stroke: a meta-analysis of 273,135 patients

Background Stroke stands among the most leading causes of mortality worldwide. Although modifiable risk factors for stroke have been identified, current risk factors do not sufficiently explain the risk in young patients. Previous studies have postulated an association between infection by Helicobac...

Full description

Saved in:
Bibliographic Details
Published in:Journal of neurology 2021-09, Vol.268 (9), p.3238-3248
Main Authors: Doheim, Mohamed Fahmy, Altaweel, Ahmad Amr, Elgendy, Mohamed Gamal, Elshanbary, Alaa Ahmed, Dibas, Mahmoud, Ali, Amira Abo Hegil Abo, Dahy, Toqa Mahmoud, Sharaf, Atef Khairy, Hassan, Ameer E.
Format: Article
Language:English
Subjects:
Immunoglobulin G
Infections
Medicine
Medicine & Public Health
Meta-analysis
Neurology
Neuroradiology
Neurosciences
Review
Risk factors
Stroke
Trinucleotide repeats
Urea
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background Stroke stands among the most leading causes of mortality worldwide. Although modifiable risk factors for stroke have been identified, current risk factors do not sufficiently explain the risk in young patients. Previous studies have postulated an association between infection by Helicobacter pylori (HP) and stroke. Objective To investigate the association between HP infection and stroke by using a systematic review and meta-analysis approach. Methods Four electronic search engines/libraries were systematically searched for relevant observational studies. Studies were screened for eligibility and data were extracted. The odds ratio (OR) and 95% confidence interval (95% CI) were combined under the random-effect model. The protocol was registered in PROSPERO (CRD42019123689). Results Among the included studies, 25 studies were analyzed for anti-HP IgG, 9 studies were for anti-Cag A, and 6 studies were for the C-urea breath test. The results showed that positive anti-HP IgG was significantly associated with an increased risk of stroke [OR (95% CI) = 1.43 (1.25–1.46)]. Similarly, both antiCag A and C-urea breath test were significantly associated with an increased risk of stroke with [OR (95% CI) = 1.77 (1.25–2.49)], and [OR (95% CI) = 2.21 (1.33–3.66)], respectively. Furthermore, our results indicated that positive anti-HP IgG was associated with stroke caused by atherothrombosis and small artery disease. Conclusions This study suggests that HP infection is significantly associated with increased risk of stroke. However, more well-designed studies are required to investigate if early HP eradication might decrease the incidence of stroke.
ISSN:0340-5354
1432-1459
DOI:10.1007/s00415-020-09933-x