Gut Liver. 2024;18(4):642-653.

Risk of Ischemic Stroke in Relation to Helicobacter pylori Infection and Eradication Status: A Large-Scale Prospective Observational Cohort Study.

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제1저자 전은비 · 교신저자 김나영

PMID 38712396 PMC11249949 DOI 10.5009/gnl230458 IF 4.1 소화기내과

소속 (4)

Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Internal Medicine and Liver Research Institute, Seoul National University, Seoul, Korea.
Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea.
Medical Research Collaborating Center, Seoul National University Bundang Hospital, Seongnam, Korea.

Abstract

BACKGROUND/AIMS : A few studies have suggested the association between Helicobacter pylori (HP) infection and ischemic stroke. However, the impact of HP eradication on stroke risk has not been well evaluated. This study aimed to assess the influence of HP eradication on the incidence of ischemic stroke, considering the potential effect of sex.

METHODS : This prospective observational cohort study was conducted at Seoul National University Bundang Hospital, from May 2003 to February 2023, and involved gastroscopy-based HP testing. Propensity score (PS) matching was employed to ensure balanced groups by matching patients in the HP eradicated group (n=2,803) in a 3:1 ratio with patients in the HP non-eradicated group (n=960). Cox proportional hazard regression analysis was used to evaluate the risk of ischemic stroke.

RESULTS : Among 6,664 patients, multivariate analysis after PS matching indicated that HP eradication did not significantly alter the risk of ischemic stroke (hazard ratio, 0.531; 95% confidence interval, 0.221 to 1.270; p=0.157). Sex-specific subgroup analyses, both univariate and multivariate, did not yield statistically significant differences. However, Kaplan-Meier analysis revealed a potential trend: the females in the HP eradicated group exhibited a lower incidence of ischemic stroke than those in the HP non-eradicated group, although this did not reach statistical significance (p=0.057).

CONCLUSIONS : This finding suggests that HP eradication might not impact the risk of ischemic stroke. However, there was a trend showing that females potentially had a lower risk of ischemic stroke following HP eradication, though further investigation is required to establish definitive evidence.

Keywords

EradicationHelicobacter pyloriIschemic strokeSex

Figures

**Fig. 1** Schematic flow of the study. HP, *Helicobacter* *pylori*.

**Fig. 2** Comparison of ischemic stroke-free rate depending on *Helicobacter* *pylori* (HP) eradication. The data revealed that there were no statistically significant differences in the ischemic stroke-free rates between the patients with and without HP eradication, both before (A) and after (B) propensity score (PS) matching. To evaluate the cumulative ischemic stroke-free rate, Kaplan-Meier estimates were utilized. Subsequently, the log-rank test was employed to compute p-values and determine whether there were any notable differences between the two groups.

**Fig. 3** Comparison of ischemic stroke-free rates between the patients depending on *Helicobacter* *pylori* (HP) eradication after propensity score matching, with a focus on sex differences. It was found that HP eradication had no observable advantage in terms of the ischemic stroke-free rate, in both female (A) and male (B) subgroups. To assess the cumulative ischemic stroke-free rate, Kaplan-Meier estimates were employed, and the p-value was calculated using the log-rank test.

그림 출처: PubMed Central 공개 논문 (PMC11249949)

Conflict of interest statement

CONFLICTS OF INTEREST . No potential conflict of interest relevant to this article was reported.

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