Helicobacter pylori screening in clinical routine during hospitalization for acute myocardial infarction

Wärme, Jonatan; Sundqvist, Martin; Mars, Katarina; Aladellie, Layth; Pawelzik, Sven-Christian; Erlinge, David; Jernberg, Tomas; James, Stefan; Hofmann, Robin; Bäck, Magnus

doi:10.1016/j.ahj.2020.10.072

Cited by 16 publications

(9 citation statements)

References 14 publications

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“…H. pylori- positive patients on combined antiplatelet therapy carry the highest risk for peptic ulcer bleeding, and H. pylori eradication is a suitable option in this frequent clinical scenario. This is currently being tested in a large Scandinavian trial in patients with myocardial infarction 394 395. In the absence of H. pylori infection, non-aspirin antiplatelet agents do not increase the risk of peptic ulcer bleeding.…”

Section: Wg 4: Gastric Cancer and Preventionmentioning

confidence: 99%

Management ofHelicobacter pyloriinfection: the Maastricht VI/Florence consensus report

Malfertheiner

Mégraud

Rokkas

et al. 2022

Gut

582

842

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Helicobacter pyloriInfection is formally recognised as an infectious disease, an entity that is now included in the International Classification of Diseases 11th Revision. This in principle leads to the recommendation that all infected patients should receive treatment. In the context of the wide clinical spectrum associated with Helicobacter pylori gastritis, specific issues persist and require regular updates for optimised management.The identification of distinct clinical scenarios, proper testing and adoption of effective strategies for prevention of gastric cancer and other complications are addressed. H. pylori treatment is challenged by the continuously rising antibiotic resistance and demands for susceptibility testing with consideration of novel molecular technologies and careful selection of first line and rescue therapies. The role of H. pylori and antibiotic therapies and their impact on the gut microbiota are also considered.Progress made in the management of H. pylori infection is covered in the present sixth edition of the Maastricht/Florence 2021 Consensus Report, key aspects related to the clinical role of H. pylori infection were re-evaluated and updated. Forty-one experts from 29 countries representing a global community, examined the new data related to H. pylori infection in five working groups: (1) indications/associations, (2) diagnosis, (3) treatment, (4) prevention/gastric cancer and (5) H. pylori and the gut microbiota. The results of the individual working groups were presented for a final consensus voting that included all participants. Recommendations are provided on the basis of the best available evidence and relevance to the management of H. pylori infection in various clinical fields.

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Section: Wg 4: Gastric Cancer and Preventionmentioning

confidence: 99%

Management ofHelicobacter pyloriinfection: the Maastricht VI/Florence consensus report

Malfertheiner

Mégraud

Rokkas

et al. 2022

Gut

582

842

View full text Add to dashboard Cite

show abstract

“…Gastrointestinal bleeding is the main source of bleeding complications in patients taking antithrombotic therapy 136 . Routine screening and eradication of Helicobacter pylori to reduce bleeding complications in patients with acute myocardial infarction has been advocated, and a large trial is ongoing 137 . Given that aspirin is associated with gastrointestinal toxicity and aspirin is the cornerstone of treatment for the secondary prevention of cardiovascular events, efforts have been made to develop aspirin formulations with a more favourable safety profile.…”

Section: Additional Strategies and Investigational Drugsmentioning

confidence: 99%

Bleeding avoidance strategies in percutaneous coronary intervention

et al. 2021

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For many years, bleeding has been perceived as an unavoidable consequence of strategies aimed at reducing thrombotic complications in patients undergoing percutaneous coronary intervention (PCI). However, the paradigm has now shifted towards bleeding being recognized as a prognostically unfavourable event to the same extent as having a new or recurrent ischaemic or thrombotic complication. As such, in parallel with progress in device and drug development for PCI, there is clinical interest in developing strategies that maximize not only the efficacy but also the safety (for example, by minimizing bleeding) of any antithrombotic treatment or procedural aspect before, during or after PCI. In this Review, we discuss contemporary data and aspects of bleeding avoidance strategies in PCI, including risk stratification, timing of revascularization, pretreatment with antiplatelet agents, selection of vascular access, choice of coronary stents and antithrombotic treatment regimens.

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“…Non-invasive screening for active H. pylori can be performed with high accuracy (sensitivity 96% and specificity 93%) by UBT (27), currently the recommended diagnostic tool (8). No contemporary data using this mode of detection were available until recently when it was shown in a Swedish multicenter prospective cohort study of 310 consecutive AMI patients that active H. pylori diagnosed by UBT were prevalent in 20% of the patients (16), in agreement with previous findings twice as common as in the overall Swedish population with an H. pylori prevalence estimated at 11% (28). Importantly, H. pylori screening and treatment were feasible in the clinical routine during MI hospitalization.…”

Section: Gastrointestinal Bleeding and Cardiovascular Diseasementioning

confidence: 99%

“…While previous studies of H. pylori eradication in cardiology aimed to reduce cardiovascular events, the effects of H. pylori eradication on reducing cardiological bleeding complications have been somewhat overlooked ( 16 ). Several strategies to reduce the risk of UGIB are available.…”

Section: Gastrointestinal Bleeding and Cardiovascular Diseasementioning

confidence: 99%

Gastro-Cardiology: A Novel Perspective for the Gastrocardiac Syndrome

Hofmann

Bäck

2021

Front. Cardiovasc. Med.

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The gastrocardiac syndrome was coined originally at the beginning of the 19th century to describe an alleged gastric-cardiopathy with reflux heartburn mimicking cardiac chest pain. Today, a wider perspective of gastrocardiac syndrome has emerged. First, the cardiovascular risk factor chronic systemic inflammation may reflect gastroenterological inflammatory conditions, such as inflammatory bowel disease and gastrointestinal infections, in particular, chronic Helicobacter pylori infection. Furthermore, since contemporary treatment of cardiovascular disease commonly includes potent antithrombotic medications, the cardiovascular benefit in terms of a decrease in the incidence of recurrent ischemic events and death needs to be carefully balanced with an increased risk of gastrointestinal bleeding. Several strategies to target chronic gastrointestinal inflammation and to diagnose and treat Helicobacter pylori to reduce the risk of cardiovascular events and gastrointestinal bleeding are available but residual controversy remains and large-scale gastro-cardiology trials are needed to determine the optimal treatment approaches. In perspective, the centennial gastrocardiac syndrome is more relevant than ever in a contemporary gastroenterology and cardiology setting. A collaborative subspecialty, namely Gastro-cardiology, would introduce novel unique means to study, diagnose and treat gastrocardiac conditions with the aim to reduce the risk of cardiovascular and bleeding events to improve the prognosis for gastro-cardiology patients.

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Helicobacter pylori screening in clinical routine during hospitalization for acute myocardial infarction

Cited by 16 publications

References 14 publications

Management ofHelicobacter pyloriinfection: the Maastricht VI/Florence consensus report

Management ofHelicobacter pyloriinfection: the Maastricht VI/Florence consensus report

Bleeding avoidance strategies in percutaneous coronary intervention

Gastro-Cardiology: A Novel Perspective for the Gastrocardiac Syndrome

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