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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doaj-bb88e487c6af49e8a73bda4af395eaae2020-11-25T00:24:19ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-01131e019021910.1371/journal.pone.0190219Association between Helicobacter pylori eradication and the risk of coronary heart diseases.Jiunn-Wei WangKuo-Lun TsengChien-Ning HsuChih-Ming LiangWei-Chen TaiMing-Kun KuTsung-Hsing HungLan-Ting YuanSeng-Howe NguangShih-Cheng YangCheng-Kun WuChien-Hua ChiuKai-Lung TsaiMeng-Wei ChangChih-Fang HuangPin-I HsuDeng-Chyang WuSeng-Kee ChuahThe 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.http://europepmc.org/articles/PMC5749777?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jiunn-Wei Wang Kuo-Lun Tseng Chien-Ning Hsu Chih-Ming Liang Wei-Chen Tai Ming-Kun Ku Tsung-Hsing Hung Lan-Ting Yuan Seng-Howe Nguang Shih-Cheng Yang Cheng-Kun Wu Chien-Hua Chiu Kai-Lung Tsai Meng-Wei Chang Chih-Fang Huang Pin-I Hsu Deng-Chyang Wu Seng-Kee Chuah |
spellingShingle |
Jiunn-Wei Wang Kuo-Lun Tseng Chien-Ning Hsu Chih-Ming Liang Wei-Chen Tai Ming-Kun Ku Tsung-Hsing Hung Lan-Ting Yuan Seng-Howe Nguang Shih-Cheng Yang Cheng-Kun Wu Chien-Hua Chiu Kai-Lung Tsai Meng-Wei Chang Chih-Fang Huang Pin-I Hsu Deng-Chyang Wu Seng-Kee Chuah Association between Helicobacter pylori eradication and the risk of coronary heart diseases. PLoS ONE |
author_facet |
Jiunn-Wei Wang Kuo-Lun Tseng Chien-Ning Hsu Chih-Ming Liang Wei-Chen Tai Ming-Kun Ku Tsung-Hsing Hung Lan-Ting Yuan Seng-Howe Nguang Shih-Cheng Yang Cheng-Kun Wu Chien-Hua Chiu Kai-Lung Tsai Meng-Wei Chang Chih-Fang Huang Pin-I Hsu Deng-Chyang Wu Seng-Kee Chuah |
author_sort |
Jiunn-Wei Wang |
title |
Association between Helicobacter pylori eradication and the risk of coronary heart diseases. |
title_short |
Association between Helicobacter pylori eradication and the risk of coronary heart diseases. |
title_full |
Association between Helicobacter pylori eradication and the risk of coronary heart diseases. |
title_fullStr |
Association between Helicobacter pylori eradication and the risk of coronary heart diseases. |
title_full_unstemmed |
Association between Helicobacter pylori eradication and the risk of coronary heart diseases. |
title_sort |
association between helicobacter pylori eradication and the risk of coronary heart diseases. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2018-01-01 |
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 between H. pylori eradication and CHD. |
url |
http://europepmc.org/articles/PMC5749777?pdf=render |
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