Helicobacter pylori infection increases subsequent ischemic stroke risk: a nationwide population-based retrospective cohort study

W.- S. Huang, C.- H. Tseng, C.- L. Lin, C.- H. Tsai, C.- H. Kao
2014 QJM: Quarterly journal of medicine  
and purpose: The association of Helicobacter pylori infection (HP-I) with ischemic stroke (IS) incidence has been studied, but conflicting results have been reported. The purpose of this study was to investigate the association between chronic HP-I and the risk of acute IS by using data from the Taiwan National Health Insurance Research Database. Methods: We identified17 332 patients with HP-I and 69 328 randomly selected age-and gendermatched controls from 1 January 2000 to 31 December 2010.
more » ... 31 December 2010. Both cohorts were followed up until the occurrence of IS or until censored. The Cox proportional hazards model was used for assessing the association of HP-I with IS. Results: Compared with the control cohort, patients diagnosed with HP-I exhibited a higher incidence rate of IS (14.8 vs. 8.45 per 1000 person years) and a hazard ratio (HR) of 1.52 (95% confidence interval [CI] = 1.40-1.65). The HRs for IS were 1.49 (1.37-1.62) in patients diagnosed with HP-I who had one admission, increasing to 2.26 (1.71-1.98) for those who had two or more admissions when adjusted for age, sex and comorbidities (P for trend < 0.0001). In addition, we observed a significantly positive association between nonembolic IS and increased admissions (P for trend < 0.0001) but negative association with embolic IS. Conclusion: Chronic HP-I is significantly associated with an increased risk of IS, particularly nonembolic IS. Anti-HP therapy may be beneficial to IS prevention.
doi:10.1093/qjmed/hcu117 pmid:24890556 fatcat:ijgrn2lb2nh7hl72wq46cydpje