Association of Helicobacter pylori infection with ischemic stroke of non-cardiac origin: the BAT.MA.N. project study

Abstract

Background/aims: Helicobacter pylori (H. pylori) infection has been associated with several vascular obstructive disorders. The infection induces the production of proinflammatory cytokines that could increase platelet aggregates in circulation. The aim of this case-controlled study was to evaluate the prevalence of H. pylori infection in patients with acute ischemic stroke not related to cardiac causes.

Methodology: A group of 80 consecutive patients (58 males, age range: 49-65 years) with acute ischemic stroke was studied. All patients received a cranial CT and/or brain magnetic resonance imaging scan, extracranial vessel duplex ultrasonography, and transthoracic echocardiography. H. pylori infection was diagnosed by means of both 13C urea breath test and IgG antibodies to H. pylori. A group of 320 blood donors (232 males and 88 females, age range: 49-65 years) matched for sex and age served as controls. Among the patients, we investigated the presence of hypertension, cholesterol and glucose levels in serum, fibrinogen in plasma and the smoking habit.

Results: The presence of H. pylori infection was higher in patients than in controls: 64/80 (80%) versus 190/320 (59.4%) (P < 0.001); when analyzed for sex in 45/58 (77.5%) among male patients and in 139/232 (59.9%) among controls (P < 0.05); of the females 19 out of 22 (86.3%) patients were infected at variance with only 51/88 (57.9%) of the controls (P < 0.05). Classical risk factors for stroke did not differ among patients with and without H. pylori infection. H. pylori infection was not differently associated with current smoking, serum total cholesterol and glucose levels, fibrinogen value in plasma and hypertension when compared to the H. pylori-negative status.

Conclusions: H. pylori infection appears to be significantly more frequent in middle-aged patients with acute ischemic stroke than in controls.