Association between atrial fibrillation and Helicobacter pylori

• Published in: Clinical research in cardiology 2019-07, Vol.108 (7), p.730-740
• Main Authors: Tetta, Cecilia, Moula, Amalia Ioanna, Matteucci, Francesco, Parise, Orlando, Maesen, Bart, Johnson, Daniel, La Meir, Mark, Gelsomino, Sandro
• Format: Article
• Language: English
• Subjects: Atrial Fibrillation - epidemiology; Atrial Fibrillation - etiology; Cardiac arrhythmia; Cardiology; Confidence intervals; Fibrillation; Global Health; Helicobacter Infections - complications; Helicobacter Infections - epidemiology; Helicobacter Infections - microbiology; Helicobacter pylori; Humans; Incidence; Infections; Medicine; Medicine & Public Health; Patients; Regression analysis; Review; Risk analysis; Risk Factors; Standard error; Statistical analysis; Statistical tests; Systematic review
• ISSN: 1861-0684; 1861-0692; 1861-0692
• DOI: 10.1007/s00392-019-01418-w

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.