Targeted H.โฃ pylori screening โคShows Promise for Reducing Bleeding Risk After Heart Attack
Stockholm, โsweden – Routine screening for the stomach โbacterium Helicobacter pylori isn’t necessary for all patients following a myocardial infarction (heart attack), but targeted testing couldโ substantially reduce โฃgastrointestinal โฃbleeding โฃrisk inโค specific high-risk groups, according to a large new study published โin JAMA. Researchers from Karolinskaโฃ Institutet andโค Sรถdersjukhuset in Sweden found a โnotably strong benefit forโ patients with anemia.The randomized study,involving nearlyโค 18,500 heart attack patientsโ across 35 Swedish hospitals,investigated whether screening for H.pylori – a common causeโ of gastritis and gastric ulcers – and subsequent treatment could lower the incidence of โupper gastrointestinal bleeding, a seriousโค complication affecting approximately 2% of patients โwithin a year of a heart attack and linked โto increased mortality and recurring cardiovascular events.
While overall results didn’t show a statistically significantโฃ reduction in bleeding across the entire study population,analysis of subgroups revealed a clear benefit. โPatients โคwith moderate to severe โanemia experienced roughly half the rate โof gastrointestinal bleeding when โundergoing H. pylori screening and treatment compared to those โขreceiving standard care. A positive effect was also observed in patients withโ kidney failure.
“Our results suggest that screening for Helicobacter pylori does notโ need to be done routinely for allโ individuals following a heart attack,” explained Dr. Robinโ Hofmann,led author of the study,senior consultant at the Department of Cardiology,Sรถdersjukhuset,and associate professor โคat the Department โof Clinical Science and Education,Sรถdersjukhuset,Karolinska Institutet. โ”On theโ other hand,testing and treatment couldโค be a meaningful complement for selected patient groups with an elevated risk of bleeding.”
The study involved testing half the group for the bacterium and treating those who tested positive with antibiotics and protein โคpump inhibitors. The other โhalf received standard post-infarction care without additional H. pylori โฃ testing or treatment. Follow-up โlasted almost two years.
Researchers are now planning further examination into the long-term effects of targeted screening and โคaim to refine identification of the patient groups who would benefit โขmost.
Theโ study was funded by the Swedishโข Research โcouncil, the Swedish Heart Lung Foundation, and Region โStockholm, and conducted in collaboration with Sรถdersjukhuset, Region Stockholm and the Uppsala Clinical โResearch Centre (UCR).
Source: Hofmann,โ R.,et al. (2025). Helicobacter pylori Screening After Acute Myocardial Infarction. JAMA. doi.org/10.1001/jama.2025.15047
