Active Helicobacter pylori Infection and Atrial Fibrillation in Patients Hospitalized With Acute Myocardial Infarction

OBJECTIVE: Chronic Helicobacter pylori (H. pylori) infection may promote systemic inflammation and has been proposed as a contributor to atrial fibrillation (AF), but clinical evidence is inconsistent. The aim of the study was to explore whether active H. pylori infection was associated with AF in patients hospitalized with acute myocardial infarction (AMI). METHODS: This cross-sectional analysis included adults from a two-center observational AMI cohort. Active H. pylori infection was assessed during hospitalization using a urea breath test (UBT). AF was defined as AF documented before admission or identified during the index hospitalization. Associations were estimated using logistic regression adjusted for age, sex, center, and smoking. Exploratory multivariable interaction analyses were also performed. RESULTS: Of 310 enrolled patients, 300 had conclusive H. pylori screening results; 60 (20.0%) were positive. AF was recorded in 4 of 60 H. pylori-positive patients (6.7%) and 30 of 240 H. pylori-negative patients (12.5%). H. pylori positivity was not significantly associated with recorded AF (unadjusted OR, 0.55; 95% CI, 0.17-1.41; p = 0.228; adjusted OR, 0.54; 95% CI, 0.16-1.46; p = 0.235). These estimates refer to pooled AF; only four AF cases occurred among patients testing positive. CONCLUSIONS: No statistically significant association was detected between H. pylori breath-test positivity and pooled documented AF among patients hospitalized with AMI, but a clinically meaningful association cannot be excluded. Larger prospective studies with longitudinal follow-up are needed to clarify whether active H. pylori infection is associated with incident AF after AMI.