Abstract
Aims: There is contrasting evidence on the relevance of chronic infection by Helicobacter pylori (H. pylori) as a risk factor for stroke. We performed a meta-analysis of case-control studies
to assess association of H. pylori infection and more virulent H. pylori strains, bearing the cytotoxin-associated gene-A (CagA) antigen, with different types
of stroke. Methods: Outcome measures were: H. pylori and CagA seroprevalence in (1) patients with stroke versus controls, and (2) patients
with stroke due to large vessel stroke versus patients with other types of stroke
and controls. Results: Seven cross-sectional, case-control studies were included. Odds ratio for individual
case-control studies and pooled OR for the association between H. pylori seropositivity and stroke was 1.49 (95% CI 1.24–1.81), for the association between
stroke and anti-CagA positivity was 2.23 (95% CI 1.49–3.36). Patients with large vessel
stroke had higher odds for H. pylori infection than patients with other types of stroke (odds ratio 1.65; 95% CI 1.12–2.45),
and than controls (odds ratio 1.61; 95% CI 1.13–2.32). Conclusions: Association between H. pylori positivity, anti-CagA positivity and stroke is modest and seems higher with stroke
due to large vessel disease. This meta-analysis suggests that the role of CagA positive
H. pylori strains in different stroke etiologic subclasses should be the target of future prospective investigation.
Keywords
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Article info
Publication history
Accepted:
December 18,
2003
Received in revised form:
November 19,
2003
Received:
August 19,
2003
Identification
Copyright
© 2004 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
