[Screening for Helicobacter pylori infection in patients with acute myocardial infarction and stable coronary artery disease: prevalence and risk factors (a single-center study)].
Deeva E, Trushina O, et al. • Terapevticheskii arkhiv • 2026
Active H. pylori infection is widespread among patients with acute myocardial infarction (46.4%) and stable coronary artery disease (31.5%), with smoking and dyspeptic complaints identified as statistically significant risk factors across both groups.
Key Findings
Results
H. pylori infection prevalence was higher in patients with acute myocardial infarction (46.4%) than in patients with stable coronary artery disease (31.5%).
Total study enrollment was 110 patients in a single-center study.
AMI group (n=54, mean age 62.00 years): 26 patients (46.4%) tested positive and 30 (53.6%) tested negative for H. pylori.
Stable CAD group (n=56, mean age 67.5 years): 17 patients (31.5%) tested positive and 37 (68.5%) tested negative for H. pylori.
Different testing methods were used: 13C-urea breath test for AMI patients and biopsy during esophagogastroduodenoscopy for stable CAD patients.
Results
Smoking was statistically significantly associated with H. pylori-positive status across both patient groups.
Association identified by univariate analysis.
The association between smoking and H. pylori-positive status persisted after adjusting for sex and age.
This finding applied across both the AMI and stable CAD groups.
Results
Presence of dyspeptic complaints was statistically significantly associated with H. pylori-positive status in both patient groups.
Association identified by univariate analysis.
The association between dyspeptic complaints and H. pylori-positive status persisted after adjusting for sex and age.
This finding applied across both the AMI and stable CAD groups.
Results
In AMI patients specifically, H. pylori infection was additionally associated with higher systolic blood pressure, decreased total protein level, and prolonged prothrombin time.
These associations were identified in the AMI subgroup (n=54).
Specific numerical thresholds or exact p-values for these associations are not reported in the abstract.
These additional associations were not reported for the stable CAD group.
Prolonged prothrombin time in H. pylori-positive AMI patients may have implications for bleeding risk in this anticoagulated population.
Results
H. pylori-positive patients were more frequently prescribed proton pump inhibitors compared to H. pylori-negative patients, while the two comparison groups were otherwise comparable in drug therapy.
The two groups (H. pylori-positive vs. negative) were comparable in terms of received drug therapy with the exception of proton pump inhibitor prescription frequency.
In the AMI group, 53 patients (94.64%) were on dual antiplatelet therapy.
In the stable CAD group, 42 patients (77.78%) were on dual antiplatelet therapy.
More frequent PPI prescription to H. pylori-positive patients was the only notable difference in medication between comparison subgroups.
Conclusions
The study identified H. pylori infection as a potentially modifiable contributor to elevated risk of gastroduodenal ulcers and hemorrhage in patients with coronary artery disease.
The patient population studied is at heightened gastrointestinal risk due to dual antiplatelet therapy use.
In the AMI group, 94.64% of patients were on dual antiplatelet therapy; in the stable CAD group, 77.78% were on dual antiplatelet therapy.
The authors describe H. pylori as 'a potentially modifiable contributor to an elevated risk of gastroduodenal ulcers and hemorrhage in this patient population.'
The findings were interpreted as supporting the value of routine H. pylori screening in this cardiac patient population.
What This Means
This research studied how common the stomach bacterium Helicobacter pylori (H. pylori) is among heart disease patients who are at particular risk for stomach bleeding — specifically those who have had a heart attack or who have stable coronary artery disease and are taking blood-thinning medications. Among 110 patients studied at a single hospital, nearly half of those who had recently had a heart attack (46.4%) tested positive for H. pylori, as did about a third of those with stable heart disease (31.5%). The study found that smokers and patients who reported stomach-related symptoms (like indigestion or stomach pain) were significantly more likely to test positive for H. pylori, even after accounting for differences in age and sex.
In heart attack patients specifically, H. pylori infection was also linked to higher blood pressure readings, lower protein levels in the blood, and slower blood clotting times — findings that may be relevant for patients already on medications that affect bleeding risk. H. pylori-positive patients were more likely to be prescribed acid-suppressing medications (proton pump inhibitors), which is consistent with clinical guidelines, but otherwise both groups received similar drug treatments.
This research suggests that active H. pylori infection is common among heart disease patients taking antiplatelet (blood-thinning) therapy, and that the infection could be a treatable factor that increases the risk of stomach ulcers and gastrointestinal bleeding in this vulnerable group. Since H. pylori can be identified and eradicated with antibiotic treatment, routine screening in cardiac patients on dual antiplatelet therapy may be clinically important. The study was limited by its single-center design and relatively small sample size, and different testing methods were used for the two patient groups.
Deeva E, Trushina O, Isaikina M, Fomin V, Pogonin A, Tamkaeva M, et al.. (2026). [Screening for Helicobacter pylori infection in patients with acute myocardial infarction and stable coronary artery disease: prevalence and risk factors (a single-center study)].. Terapevticheskii arkhiv. https://doi.org/10.26442/00403660.2026.08.203725