Helicobacter pylori Infection Maybe a Risk Factor for Cardiac Syndrome X

Dong-Hong Zhang; Chen Yuan; Bei-Bei Wang; Xin-Jiang Dong; Shu-Ping Lv; Fei-Hong Li; Zhen-Xiu Hou; Xiao-Li Liu; Kang Chen

doi:10.3389/fcvm.2022.823885

Helicobacter pylori Infection Maybe a Risk Factor for Cardiac Syndrome X

Front Cardiovasc Med. 2022 Jul 15:9:823885. doi: 10.3389/fcvm.2022.823885. eCollection 2022.

Authors

Dong-Hong Zhang¹, Chen Yuan², Bei-Bei Wang³, Xin-Jiang Dong⁴, Shu-Ping Lv⁵, Fei-Hong Li⁶, Zhen-Xiu Hou³, Xiao-Li Liu⁷, Kang Chen²

Affiliations

¹ Department of Infection Disease, Shanghai Fifth People's Hospital, Shanghai, China.
² Department of Emergency, Shanghai Fengxian District Central Hospital, Shanghai Jiao Tong University Affiliated Sixth People's Hospital South Campus, Shanghai, China.
³ Department of Cardiology, The First People's Hospital of Jinzhong, Jinzhong, China.
⁴ Department of Cardiology, Shanxi Cardiovascular Hospital, Taiyuan, China.
⁵ Department of Cardiology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan, China.
⁶ Department of Cardiology, Yantai Yeda Hospital, Yantai, China.
⁷ Department of Cardiology, Yun Cheng Central Hospital, Yuncheng, China.

Abstract

Purpose: Cardiac syndrome X (CSX) is a condition with normal coronary angiography but angina pectoris. Chronic inflammation caused by Helicobacter pylori (H. pylori) infection may play a pathogenic role in CSX. Therefore, we conducted a meta-analysis to explore the relationship between H. pylori infection and risk of CSX.

Methods: A systematic search in the Web of Science, Medline, Embase and Chinese databases (CNKI and Wanfang) was conducted up to October 2021. Articles on the association between H. pylori infection and the risk of CSX were included and were analyzed by R software (version 4.1.0).

Results: Ten case-control studies involving 703 CSX patients and 731 healthy controls were included. H. pylori infection was associated with an increased risk of CSX (OR: 8.29, 95% CI: 4.64-14.82). We also found a significant association in those 25-40 years of age (OR: 1.34, 95% CI: 1.04-1.72), those 40-50 years of age (OR: 11.27, 95% CI: 4.29-29.61), those over 50 years of age (OR: 7.18, 95% CI: 3.59-14.36), those in developing countries [Iran (OR: 12.99, 95% CI: 8.61-19.60) and China (OR: 5.14, 95% CI: 3.09-8.56)]. However, this association was not apparent in a developed country [Italy (OR: 0.93, 95% CI: 0.37-2.33)].

Conclusions: Our study suggested a possible association between H. pylori infection and the risk of CSX. Its pathogenicity is stronger in middle-aged individuals and some developing countries. However, more studies are needed to further investigate whether early eradication of H. pylori can reduce the incidence rate of CSX, especially in middle-aged individuals and some developing countries.

Keywords: Cardiac syndrome X; Helicobacter pylori infection; cytotoxin-associated gene A; meta-analysis; systematic review.

Publication types

Systematic Review