Association between Helicobacter pylori eradication and the risk of coronary heart diseases

The evidences on the association of Helicobacter pylori (H. pylori) to coronary heart diseases (CHD) are conflicting. In order to answer this important but yet unanswered clinical health issue, a large cohort study such as big data from the Taiwan National Health Insurance Research Database should b...

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Published in:PloS one 2018-01, Vol.13 (1), p.e0190219
Main Authors: Wang, Jiunn-Wei, Tseng, Kuo-Lun, Hsu, Chien-Ning, Liang, Chih-Ming, Tai, Wei-Chen, Ku, Ming-Kun, Hung, Tsung-Hsing, Yuan, Lan-Ting, Nguang, Seng-Howe, Yang, Shih-Cheng, Wu, Cheng-Kun, Chiu, Chien-Hua, Tsai, Kai-Lung, Chang, Meng-Wei, Huang, Chih-Fang, Hsu, Pin-I, Wu, Deng-Chyang, Chuah, Seng-Kee
Format: Article
Language:English
Subjects:
Age
Biology and Life Sciences
Cardiovascular disease
Cardiovascular diseases
Care and treatment
Comorbidity
Complications and side effects
Coronary artery disease
Coronary heart disease
Data management
Data processing
Demographics
Development and progression
Eradication
Health risks
Heart diseases
Helicobacter infections
Helicobacter pylori
Hypertension
Medicine and Health Sciences
Mortality
Multivariate analysis
Patient outcomes
Patients
People and Places
Physical Sciences
Research and Analysis Methods
Risk analysis
Risk factors
Sensitivity analysis
Studies
Therapy
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Summary:The evidences on the association of Helicobacter pylori (H. pylori) to coronary heart diseases (CHD) are conflicting. In order to answer this important but yet unanswered clinical health issue, a large cohort study such as big data from the Taiwan National Health Insurance Research Database should be more convincing. Therefore, we aimed to make use of these big data source to analyze and clarify the relevance of H. pylori eradication and CHD risks. We looked through a total of 208196 patients with peptic ulcer diseases (PUD) from the years of 2000 to 2011. First, 3713 patients who received H. pylori eradication within 365 days of the index date were defined as the group A. We randomly selected the same number of patients as cohort A from 55249 non-eradication patients to be the comparison group B using propensity scores (including age, gender and comorbidity) so that we could control the confounding variables of CHD and mortality. Importantly, we perform sensitivity analysis for the time-dependent association between H. pylori eradication and risk of CHD, interactions between patient demographic characteristics and therapy by age (≥ or < 65 years old). The results showed that a trend of decreased association of CHD in patients with early eradication was observed compared to those without eradication (2.58% vs. 3.35%, p = 0.0905). The mortality rate was lower in early eradication subgroup compared to cohort B (2.86% vs. 4.43%, p = 0.0033). Interestingly, there was also significant difference observed in composite end-points for CHD and death in the early eradication subgroup (0.16% vs.0.57%, p = 0.0133). Further, the cumulative CHD rate was significantly lower in younger patients (< 65 years old) with H. pylori eradication therapy started < 1 year compared to those patients without eradication at all (p = 0.0384); the treatment did not appear to have an effect in older patients (≥ 65 years old) (p = 0.1963). Multivariate analysis showed that hypertension and renal diseases were risk factors for CHD in patients without eradication whilst younger age (< 65 years old) initiated with H. pylori therapy was a protective factor. In conclusion, the trend of decrease in CHD occurrence after early H. pylori eradication in addition to the significant decrease in composite end points for CHD and death, the significantly lower cumulative CHD rate in younger patients < 65 years old with H. pylori treated within 365 days suggested that there was positive association betwe
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0190219