High prevalence of Cag-A positive H. pylori strains in ischemic stroke: a primary care multicenter study.
BACKGROUND
Previous studies suggested an association between CagA-positive H. pylori strains and ischemic stroke. The aim of the present study was to assess the prevalence of Helicobacter pylori infection and CagA status in patients with atherosclerotic stroke in the primary care setting.


METHODS
A total of 106 consecutive patients (age 76.6 +/- 8 years; males 52%) with well-documented history of atherosclerotic stroke and 106 sex-age- (age 76.5 +/- 9 years; males 52%) and social background-matched controls without relevant vascular diseases. Risk factors for ischemic stroke were recorded in all subjects. H. pylori infection was assessed by[13]C-urea breath test. A serologic assay for specific IgG against CagA was performed in infected subjects.


RESULTS
A trend toward a higher prevalence of H. pylori was observed in cases (63%) with respect to controls (54%) without reaching a statistical significance. CagA positivity was associated to a higher risk of atherosclerotic stroke (adjusted odds ratio 2.69, 95% confidence interval 1.37-5.30).


CONCLUSIONS
Our findings suggest that CagA-positive strains of H. pylori are significantly associated to atherosclerotic stroke. This is not a merely confirmative study since it has been performed for the first time in the primary care setting and included only subjects with an active infection.
De Bastiani
Rudy
R
GIGA-CP (Italian Group for Primary Care Gastroenterology), Feltre (BL) Italy.
Gabrielli
Maurizio
M
Ubaldi
Enzo
E
Benedetto
Edoardo
E
Sanna
Guido
G
Cottone
Carmelo
C
Candelli
Marcello
M
Zocco
Maria Assunta
MA
Zocco Maria
Assunta
A
Saulnier
Nathalie
N
Santoliquido
Angelo
A
Papaleo
Pierangelo
P
Gasbarrini
Giovanni
G
Gasbarrini
Antonio
A
D000368:Aged; D000369:Aged, 80 and over; D000942:Antigens, Bacterial / Q000097:blood / Q000276:immunology*; D001426:Bacterial Proteins / Q000097:blood / Q000276:immunology*; D001944:Breath Tests; D002247:Carbon Isotopes / Q000378:metabolism; D016022:Case-Control Studies; D005260:Female; D016481:Helicobacter Infections / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology; D016480:Helicobacter pylori / Q000145:classification / Q000276:immunology* / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000382:microbiology*; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data; D012307:Risk Factors; D020521:Stroke / Q000382:microbiology*
D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D002247:Carbon Isotopes; C080866:cagA protein, Helicobacter pylori