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Association Between Helicobacter Pylori Infection and Long-term Outcome in Patients with Drug-eluting Stent
Rui Wang1, Lei-Lei Chen1, De-Zhao Wang1
1Department of Cardiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China.
Insights
Helicobacter pylori infection predicts major adverse cardiac events and upper GI bleeding in acute coronary syndrome patients. Eradicating H. pylori may reduce GI bleeding risk but not cardiac events.
Area of Science:
- Cardiology
- Gastroenterology
- Infectious Diseases
Background:
- Helicobacter pylori (Hp) infection is common and linked to various health issues.
- Acute coronary syndrome (ACS) patients with drug-eluting stents (DES) require long-term management.
- The impact of Hp infection on ACS outcomes and the benefit of eradication therapy remain under investigation.
Purpose of the Study:
- To assess the association between Hp infection and long-term outcomes in ACS patients treated with DES.
- To evaluate the role of Hp eradication therapy in preventing major adverse cardiac events (MACE) and upper gastrointestinal bleeding (UGIB).
Main Methods:
- A cohort of 539 ACS patients with DES implantation was analyzed.
- Patients were stratified into Hp-infected (n=253) and Hp-uninfected (n=286) groups based on 13C urea breath test.
- Survival analysis was employed to evaluate the correlation of Hp infection with MACE and UGIB over 3-5 years.
Main Results:
- Hp infection was identified as a significant predictor for both MACE and UGIB.
- Sub-group analysis revealed no association between Hp eradication therapy and MACE.
- Patients undergoing Hp eradication therapy demonstrated a significantly lower rate of UGIB compared to those without eradication.
Conclusions:
- Hp infection is a risk factor for adverse outcomes, including MACE and UGIB, in ACS patients with DES.
- Hp eradication therapy appears beneficial in reducing UGIB risk in this patient population.
- Further research is warranted to clarify the complex relationship between Hp infection, cardiac events, and gastrointestinal health in ACS patients.
Abstract:
To investigate the relationship between Helicobacter pylori (Hp) infection and the long-term outcome in acute coronary syndrome (ACS) patients with drug-eluting stent (DES) implantation and so as to explore the significance of Hp eradication therapy in preventing major adverse cardiac events (MACE) and upper gastrointestinal bleeding (UGIB). 539 ACS patients with DES implantation from January 1, 2010 to December 31, 2012 were analyzed. All the patients were divided into two groups according to the result of 13C urea breath test. 253 patients with Hp infection were put into group A (Hp+), and 286 cases without Hp infection were put into group B (Hp-). Demographic data was collected and all patients went through biochemical indicators and other routine blood examinations. We explored the correlations of Hp infection with MACE and UGIB after 3 to 5 years of follow-up using survival analysis. Survival analysis showed that Hp infection was a predictor of MACE and UGI. Sub-group analysis showed that patients with Hp eradication therapy had no relationship with MACE but had a lower rate of UGIB than those without Hp eradication therapy.
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