A Meta-Analysis of the Association between Helicobacter pylori Infection and Risk of Coronary Heart Disease from Published Prospective Studies

Background: The association between helicobacter pylori (Hp) infection and coronary heart disease (CHD) has long been debated, and the results from previous meta-analysis are varied. Aims: The aim for this study was to identify the association between Hp and CHD using published perspective cohort studies. Materials and Methods: A systematic review and meta-analysis were performed on studies published from January, 1992 to April, 2014. All studies included used data from prospective cohort studies of CHD events or CHD deaths. Random effect models were applied in all estimations. Results: H. pylori infection increased the risk of CHD events by 11% (19 studies, n = 22,207, risk ratio (RR) = 1.11, 95% confidence interval (CI): 1.01-1.22). This effect was greater for studies that had less than 5 years' follow- up time (RR = 1.15, 95% CI: 1.00-1.32). However, this effect was not significant for studies that had follow-up times = 10 years (n = 5100, RR = 1.04, 95% CI: 0.87-1.24). Neither Cag-A seropositive nor Cag-A seronegative strains of H. pylori were associated with a significantly increased risk of CHD events or deaths based on the current published data. Conclusion: In conclusion, H. pylori infection increased the risk of CHD events, especially in a patient's early life, but this association was weaker or might be masked by other CHD risk factors in long-term observations.