Helicobacter pylori Infection and Thoracic Aortic Aneurysm: Insights from Mendelian randomization

The association between Helicobacter pylori (H. pylori) infection and the development of thoracic aortic aneurysm (TAA) remains inconclusive. Globally, approximately 58% of the population is infected with Helicobacter pylori. It is typically associated with chronic gastritis, peptic ulcers, and gastric cancer1. Mendall et al. were the first to report a serological correlation between H. pylori seropositivity and coronary heart disease2, a finding that has gradually spurred interest in the potential role of the bacterium in the pathogenesis of cardiovascular diseases. Previous studies have demonstrated an association between H. pylori-specific serotypes and acute ascending aortic dissection, particularly highlighting the chronic infection with the CagA-VacA s1m1 subtype, which is closely linked to an increased risk of aortic rupture3. Recent studies have suggested that the eradication of H. pylori is associated with a reduced incidence of abdominal aortic aneurysm in patients with peptic ulcer disease4. However, the causal relationship between H. pylori seropositivity and TAA remains unclear. In this study, we employed Mendelian randomization (MR) analysis to explore the potential causal link between H. pylori infection and TAA with the aim of providing further evidence supporting their association.