Evidence map›Paper›PMID 41834132›Full record

ArticleHelicobacter

Helicobacter pylori, Inflammation, and Long-Term Outcome in Patients With Acute Myocardial Infarction: A Prospective Cohort Study.

Martin O Sundqvist, Jonatan Wärme, Marcus Hjort, Per Tornvall, Tomas Jernberg, Bertil Lindahl, Alexandru Schiopu, Tomasz Baron, Stefan H Jacobson, Thomas Kahan and 3 more

Abstract read
In one paragraph

Article in Helicobacter. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Martin O SundqvistDepartment of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.ORCID https://orcid.org/0000-0003-3750-6075
Jonatan WärmeDepartment of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.ORCID https://orcid.org/0000-0002-2127-070X
Marcus HjortDepartment of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
Per TornvallDepartment of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.ORCID https://orcid.org/0000-0002-7529-1338
Tomas JernbergDivision of Cardiovascular Medicine, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
Bertil LindahlUppsala Clinical Research Center and Department of Medical Sciences, Uppsala University, Uppsala, Sweden.ORCID https://orcid.org/0000-0002-5795-0061
Alexandru SchiopuDepartment of Translational Medicine, Lund University, Malmö, Sweden.ORCID https://orcid.org/0000-0002-7587-5050
Tomasz BaronUppsala Clinical Research Center and Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
Stefan H JacobsonDivision of Nephrology, Department of Clinical Sciences, Karolinska Institutet Danderyd Hospital, Stockholm, Sweden.
Thomas KahanDivision of Cardiovascular Medicine, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
David ErlingeDepartment of Cardiology, Clinical Sciences, Lund University, Lund, Sweden.ORCID https://orcid.org/0000-0003-3042-5766
Jonas SpaakDivision of Cardiovascular Medicine, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
Robin HofmannDepartment of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.

Funding

Hjärt-Lungfonden 2021-0273Hjärt-Lungfonden 2021-0275Hjärt-Lungfonden 2024-0419Stockholm läns landsting 2010-0289Stockholm läns landsting 2012-0517Stockholm läns landsting 2020-0314Stockholm läns landsting 2021-0933Stockholm läns landsting 2022-0674Vetenskapsrådet 2019-00414
6 · The paper itself

Abstract

backgroundHelicobacter pylori (Hp) and its virulence factor Cytotoxin-associated gene A (CagA) have been linked to myocardial infarction (MI), but the mechanisms are unknown. This study aims to test if Hp infection and CagA are associated with pre-specified inflammatory and vascular biomarkers in patients with MI and to explore whether a broader biomarker panel can predict infection. Furthermore, it aims to investigate the association of Hp infection and biomarkers with major adverse cardiovascular events (MACE) and mortality. MATERIALS AND

methodsHp, CagA serology, and 175 cardiovascular biomarkers were analyzed in 1061 patients with MI admitted between 2008 and 2014. Associations between Hp and seven pre-selected biomarkers were evaluated. Exploratory analyses included all biomarkers using machine-learning models to predict Hp-status. Hp-status and the top predictors were analyzed for associations with outcomes using Cox regression.

resultsMedian age was 65 years; 78% were male. Hp and CagA seroprevalence were 45% and 19%, respectively. Patients with Hp had elevated CRP (β = 0.26, 95% CI 0.01-0.51). Predictive performance of Hp-status was moderate (AUC 0.63-0.68). Exploratory analysis identified higher levels of C-C motif chemokine ligand 20 (CCL20) and immunoglobulin heavy constant gamma-3 (IGHG3), and lower levels of TNF-related apoptosis-inducing ligand (TRAIL) in patients with Hp-positivity. Elevated CCL20 and reduced TRAIL, but not Hp, were associated with MACE and all-cause mortality.

conclusionsHp may contribute to an inflammatory response in patients with MI, indicated by higher CRP and inflammatory/immune-modulatory biomarkers emerging as its top predictors. Although Hp was not associated with adverse outcomes after MI, its predictive inflammatory biomarkers were associated with MACE and mortality.

trial registrationThe study was not registered as a clinical trial, as it was an observational study.

Indexed as

Helicobacter InfectionsHelicobacter pyloriInflammationMyocardial InfarctionAgedAntibodies, BacterialAntigens, BacterialBacterial ProteinsBiomarkersFemaleHumansMaleMiddle AgedProspective StudiesAntibodies, BacterialAntigens, BacterialBacterial ProteinsBiomarkerscagA protein, Helicobacter pyloribiomarkerscoronary heart diseaseHelicobacter pyloriinflammationmyocardial infarction

Identifiers

PMID41834132
PMCPMC12989639

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.