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Association between infection with Helicobacter pylori and cerebral noncardioembolic ischemic stroke
S A Masoud1, M A Arami, E Kucheki
1Neurology Department, Shahid Beheshty Hospital, Kashan University of Medical Sciences, Iran. arami_ma@yahoo.com
Insights
This study found a link between prior Helicobacter pylori infection and noncardioembolic ischemic stroke. Evidence suggests the immune response to H. pylori may be a risk factor for this type of stroke.
Area of Science:
- Neurology
- Infectious Diseases
- Cardiovascular Research
Background:
- Helicobacter pylori infection is linked to coronary artery atherosclerosis.
- The association between H. pylori and cerebral noncardioembolic ischemia is unclear.
Purpose of the Study:
- To investigate the association between H. pylori infection and noncardioembolic ischemic stroke using a case-control design.
Main Methods:
- A case-control study included patients with first ischemic stroke and matched controls.
- Exclusion criteria targeted patients with cardiac sources of emboli or major stroke risk factors.
- Enzyme immunoassay measured IgG and IgA antibodies to H. pylori.
Main Results:
- Seropositivity for H. pylori was higher in stroke cases (72.5%) compared to controls (56.3%).
- Mean serum IgG levels were significantly elevated in the stroke group (P < 0.005).
- IgA antibody elevation did not show a significant association with stroke risk.
Conclusions:
- The study provides evidence for an association between the immune response to H. pylori and noncardioembolic ischemic stroke.
- Prior H. pylori infection, indicated by immune response, may be a marker for increased risk of noncardioembolic ischemic stroke.
Background:
Helicobacter pylori infection has been associated epidemiologically and pathogenetically with atherosclerosis of coronary arteries but data regarding chronic infection with this organism and cerebral noncardioembolic ischemia are not clear.
Aims And Design:
In this study we have investigated the association of this pathogen and noncardioembolic ischemic stroke under a case-control study.
Methods And Material:
Samples are taken among patients who were admitted in our hospital due to their first ischemic stroke during 2003-04. Patients with a known cardiac origin for cerebral emboli and those with major risk factors of ischemic strokes were excluded. Controls were selected from the study population and matched for age, sex, and area of residence. IgG and IgA antibodies to H. pylori were measured by enzyme immunoassay.
Statistical Analysis:
The t and c - tests and Odds ratio were applied to examine variables differences.
Results:
A total of 91 cases (43 women, 48 men) and 80 controls (40 women, 40 men) were included for analysis (P = 0.8). The mean age of cases was 64.3+/-10 years and of controls was 61.73 +/- 10.3 years (P = 0.1, CI = 95%). There was seropositivity for H. pylori (IgG or IgA) in 66 patients (72.5%) but they were positive only in 45 controls (56.3%) (P =0.04). Mean of serum IgG levels was significantly high in stroke group (P < 0.005) but the IgA antibody elevation against H. pylori did not show any risk.
Conclusions:
Our case-control study provides evidence of an association between the immune response to H. pylori , a marker of prior infection with this organism and noncardioembolic ischemic stroke.
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