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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 |
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creator | 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 |
description | 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 |
doi_str_mv | 10.1371/journal.pone.0190219 |
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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 between H. pylori eradication and CHD.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0190219</identifier><identifier>PMID: 29293574</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>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</subject><ispartof>PloS one, 2018-01, Vol.13 (1), p.e0190219</ispartof><rights>COPYRIGHT 2018 Public Library of Science</rights><rights>2018 Wang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 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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 between H. pylori eradication and CHD.</description><subject>Age</subject><subject>Biology and Life Sciences</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular diseases</subject><subject>Care and treatment</subject><subject>Comorbidity</subject><subject>Complications and side effects</subject><subject>Coronary artery disease</subject><subject>Coronary heart disease</subject><subject>Data management</subject><subject>Data processing</subject><subject>Demographics</subject><subject>Development and progression</subject><subject>Eradication</subject><subject>Health risks</subject><subject>Heart diseases</subject><subject>Helicobacter 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Collection</collection><collection>Genetics Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, Jiunn-Wei</au><au>Tseng, Kuo-Lun</au><au>Hsu, Chien-Ning</au><au>Liang, Chih-Ming</au><au>Tai, Wei-Chen</au><au>Ku, Ming-Kun</au><au>Hung, Tsung-Hsing</au><au>Yuan, Lan-Ting</au><au>Nguang, Seng-Howe</au><au>Yang, Shih-Cheng</au><au>Wu, Cheng-Kun</au><au>Chiu, Chien-Hua</au><au>Tsai, Kai-Lung</au><au>Chang, Meng-Wei</au><au>Huang, Chih-Fang</au><au>Hsu, Pin-I</au><au>Wu, Deng-Chyang</au><au>Chuah, Seng-Kee</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association between Helicobacter pylori eradication and the risk of coronary heart diseases</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2018-01-02</date><risdate>2018</risdate><volume>13</volume><issue>1</issue><spage>e0190219</spage><pages>e0190219-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><notes>Competing Interests: The authors have declared that no competing interests exist.</notes><abstract>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 between H. pylori eradication and CHD.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>29293574</pmid><doi>10.1371/journal.pone.0190219</doi><tpages>e0190219</tpages><orcidid>https://orcid.org/0000-0002-8934-3223</orcidid><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 1932-6203 |
ispartof | PloS one, 2018-01, Vol.13 (1), p.e0190219 |
issn | 1932-6203 1932-6203 |
language | eng |
recordid | cdi_plos_journals_1983902008 |
source | PubMed Central (Open access); ProQuest - Publicly Available Content Database |
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 |
title | Association between Helicobacter pylori eradication and the risk of coronary heart diseases |
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