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Meta-Analysis
. 2025 Mar 18;24(1):18.
doi: 10.1186/s12941-025-00788-6.

Beyond the gut: a comprehensive meta-analysis on Helicobacter pylori infection and cardiovascular complications

Somayeh Yaslianifard  1 , Fatemeh Sameni  2   3 , Kimia Kazemi  1 , Yousef Atefpour  1 , Bahareh Hajikhani  4 , Ali Baradaran Bagheri  5 , Shahrooz Yazdani  6   7 , Masoud Dadashi  8   9
Affiliations
Meta-Analysis

Beyond the gut: a comprehensive meta-analysis on Helicobacter pylori infection and cardiovascular complications

Somayeh Yaslianifard et al. Ann Clin Microbiol Antimicrob. .

Abstract

Background: Helicobacter pylori (H. pylori) is known to induce chronic inflammatory conditions, and interactions between the host immune system and pathogen have diverted attention toward investigating its correlation with extra-gastrointestinal disorders.

Objective: The present study aimed to assess the rate of H. pylori infection in cardiovascular disease (CVD) through a systematic review and meta-analysis.

Methods: We conducted a large-scale meta-analysis to determine the prevalence rates of H. pylori infection in vascular diseases. Articles from PubMed/Medline, Web of Science, and Embase databases published between 2000 and 2023 were included for analysis. We used multiple independent observers to extract data, calculated the pooled frequency of H. pylori in vascular diseases using a random effect model, and reported the results as a weighted average based on the study population. The main outcome measures were presented with 95% confidence intervals (CI).

Results: In 87 included studies, the prevalence of H. pylori infection in vascular diseases was 56.7% worldwide. 14.25% of H. pylori isolates harbored the cagA gene. The predominant vascular complication was coronary artery disease (CAD) (31.07%), primarily documented in Europe. This meta-analysis revealed a declining emphasis on studying the association of H. pylori infection with vascular disease in recent times.

Conclusion: According to this meta-analysis, H. pylori infection has a high frequency in CVD and may increase the risk of vascular diseases. However, further research is required, particularly in nations with limited data.

Keywords: Helicobacter pylori; cagA; Cardiovascular disease; Coronary artery disease.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of study selection for inclusion in the systematic review
Fig. 2
Fig. 2
Global CVD rates among patients with H. pylori during 1998–2023
Fig. 3
Fig. 3
Frequency of H. pylori among patients with CVD worldwide
Fig. 4
Fig. 4
forest plot of the meta-analysis on the prevalence of H. pylori among patients with CVD worldwide
Fig. 5
Fig. 5
funnel plot of the meta-analysis on the prevalence of H. pylori among patients with CVD worldwide
Fig. 6
Fig. 6
Frequency of H. pylori among patients with CVD in different continents
Fig. 7
Fig. 7
forest plot of the meta-analysis on the prevalence of H. pylori among patients with CVD in different continents
Fig. 8
Fig. 8
funnel plot of the meta-analysis on the prevalence of H. pylori among patients with CVD in different continents
See this image and copyright information in PMC

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