Association between Helicobacter pylori eradication and the risk of coronary heart diseases

January Association between Helicobacter pylori eradication and the risk of coronary heart diseases Jiunn-Wei Wang 0 1 Kuo-Lun Tseng 0 1 Chien-Ning Hsu 1 2 Chih-Ming Liang 1 Wei- Chen Tai 1 Ming-Kun Ku 1 Tsung-Hsing Hung 1 Lan-Ting Yuan 1 Seng-Howe Nguang 1 Shih-Cheng Yang 1 Cheng-Kun Wu 1 Chien-Hua Chiu 1 Kai-Lung Tsai 1 Meng- wei Chang 1 Chih-Fang Huang 1 Pin-I Hsu 1 Deng-Chyang Wu 0 1 Seng-Kee Chuah 1 0 Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University , Kaohsiung, Taiwan , 2 Division of Gastroenterology, Kaohsiung Municipal Ta- Tung Hospital , Kaohsiung, Taiwan , 3 Division of Gastroenterology, Cishan Hospital , Kaohsiung , Taiwan 1 Editor: Masaru Katoh, National Cancer Center , JAPAN 2 Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital , Kaohsiung, Taiwan , 5 School of Pharmacy, Kaohsiung Medical University , Kaohsiung, Taiwan , 6 Division of Hepato-gastroenterology; Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital , Kaohsiung, Taiwan , 7 Chang Gung University, College of Medicine, Kaohsiung, Taiwan, 8 Division of Gastroenterology, FooYin University Hospital , Pin-Tung, Taiwan , 9 Division of Hepato-gastroenterology; Department of Internal Medicine, Buddist Tzu Chi General Hospital , Dalin Branch, Chia-Yi, Taiwan , 10 Divisions of Gastroenterology, Yuan General Hospital , Kaohsiung, Taiwan , 11 Division of Gastroenterology, Ping-Tung Christian Hospital , Pin-Tung, Taiwan , 12 Division of Nephrology; Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital , Kaohsiung, Taiwan , 13 Division of Colon and Rectal Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital , Kaohsiung, Taiwan , 14 Departmemt of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital , Kaohsiung, Taiwan , 15 Division of Family physician, Kaohsiung Chang Gung Memorial Hospital , Kaohsiung, Taiwan , 16 Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, National Yang-Ming University , Kaohsiung , Taiwan The evidences on the association of Helicobacter pylori (H. pylori) to coronary heart diseases (CHD) are conflicting. In order to answer this important but yet unanswered clinical health issue, a large cohort study such as big data from the Taiwan National Health Insurance Research Database should be more convincing. Therefore, we aimed to make use of these big data source to analyze and clarify the relevance of H. pylori eradication and CHD risks. We looked through a total of 208196 patients with peptic ulcer diseases (PUD) from the years of 2000 to 2011. First, 3713 patients who received H. pylori eradication within 365 days of the index date were defined as the group A. We randomly selected the same number of patients as cohort A from 55249 non-eradication patients to be the comparison group B using propensity scores (including age, gender and comorbidity) so that we could control the confounding variables of CHD and mortality. Importantly, we perform sensitivity analysis for the time-dependent association between H. pylori eradication and risk of CHD, interactions between patient demographic characteristics and therapy by age ( or < 65 years old). The results showed that a trend of decreased association of CHD in patients with early eradication was observed compared to those without eradication (2.58% vs. 3.35%, p = 0.0905). The mortality rate was lower in early eradication subgroup compared to cohort B (2.86% vs. 4.43%, p = 0.0033). Interestingly, there was also significant difference - Data Availability Statement: All relevant data are within the paper and its Supporting Information files. Funding: This study was supported partially by grants from Kaohsiung Medical University Aim for the Top Universities Grant (grant no. KMUTP105G00, KMU-TP105G01) to Deng-Chyang Wu and Kaohsiung Municipal Ta-Tung Hospital (NHIRD-1050910) to Jiunn-Wei Wang. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing interests: The authors have declared that no competing interests exist. Abbreviations: CCI, Charlson comorbidity index; CHD, coronary heart disease; CI, confidence interval; H. pylori, Helicobacter pylori; H2RA, histamin-2 receptor antagonists; HIV, human immunodificiency virus; HR, hazard ratio; ICD-9CM, International Classifications of Diseases, Revision 9, Clinical Modification; NHI, National Health Insurance; NHIRD, National Health Research Institute database; PPI, proton pump inhibitors; PUD, peptic ulcer diseases; SD, standard deviation. observed in composite end-points for CHD and death in the early eradication subgroup (0.16% vs.0.57%, p = 0.0133). Further, the cumulative CHD rate was significantly lower in younger patients (< 65 years old) with H. pylori eradication therapy started < 1 year compared to those patients without eradication at all (p (...truncated)