Objective:To evaluate the correlation between Helicobacter pylori and atrial fibrillation and its possible mechanism.Methods:Eight databases at home and abroad were searched until December 2022.Studies of the correlation between Helicobacter pylori and atrial fibrillation were collected.After literature screening,data extraction,and quality evaluation were performed by two researchers,statistical analysis was performed using RevMan 5.3 software.Results:A total of 16 literatures were included,including 15 case-control studies and 1 cohort study.The total sample size of the case-control study was 3 183 cases,there were 1 553 cases of Helicobacter pylori positive cases,180 cases of cohort study and 39 cases of atrial fibrillation.The overall quality of the included study was better.Meta-analysis showed that Helicobacter pylori increased the risk of atrial fibrillation(OR=2.14,95％CI 1.82-2.52,P<0.000 01).Subgroup analysis showed that Helicobacter pylori increased the risk of atrial fibrillation in Asian(OR=2.24,95％CI 1.86-2.71,P<0.000 01)and African populations(OR=4.87,95％CI 2.49-9.52,P<0.000 01),Helicobacter pylori was not associated with atrial fibrillation in European and American populations.Serum high density lipoprotein cholesterol(HDL-C)level was lower in patients with atrial fibrillation and positive Helicobacter pylori than that of patients with atrial fibrillation and negative Helicobacter pylori(MD=-0.33,95％CI-0.50--0.17,P<0.000 1),serum C-reactive protein(CRP)(SMD=2.02,95％CI 0.53-3.50,P=0.008)and homocysteine(Hcy)(MD=7.77,95％CI 5.43-10.12,P<0.000 1)levels were higher than that of patients with atrial fibrillation and negative Helicobacter pylori.The funnel plot showed that the distribution of the included literature was basically symmetrical,suggesting a small possibility of publication bias.Conclusion:Current research evidence suggests that Helicobacter pylori increases the risk of atrial fibrillation in Asian and African populations.Helicobacter pylori may promote cardiac inflammation and oxidative stress by affecting serum HDL-C,CRP,Hcy,and other related indicators,leading to atrial electrical remodeling and structural remodeling,causing the occurrence and development of atrial fibrillation.Due to the limited number and quality of included studies,more high-quality studies are needed for validation in the future.
atrial fibrillationHelicobacter pylorihigh density lipoprotein cholesterolC-reaction proteinhomocysteineMeta-analysis
NETL
NSTL
万方数据
