[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-435574-105":59,"doc-detail-435574-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","should-h-pylori-screening-be-integrated-into-micare-protocols-editorial","Should H. pylori screening be integrated into MIcare protocols? - Editorial","","Helicobacter pylori is a modifiable risk factor linked to increased post-myocardial infarction (MI) upper gastrointestinal bleeding, intensified by antithrombotic therapy and additional mechanisms. High prevalence after MI supports screening and timely eradication as a potential cost-effective strategy. Evidence also suggests involvement in ACS pathophysiology and MI triggering, though long-term benefits remain uncertain. Targeted screening in high-risk groups appears preferable to blanket testing; subgroup analyses and long-term follow-up are needed, with biomarkers and genetics suggested for risk stratification.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/should-h-pylori-screening-be-integrated-into-micare-protocols-editorial/435574/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/should-h-pylori-screening-be-integrated-into-micare-protocols-editorial/435574.png","ImageObject",300,407,{"name":92,"@type":93},"PakDamar76","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is H. pylori screening considered for post-myocardial infarction care?","Question",{"text":112,"@type":113},"H. pylori infection is associated with an increased risk of post-MI upper gastrointestinal bleeding and may also contribute to ACS mechanisms. It is considered potentially modifiable, making detection and eradication clinically relevant.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Is universal (blanket) H. pylori screening supported by current trial evidence?",{"text":117,"@type":113},"Current randomized controlled trials suggest targeted screening in high-risk populations may be beneficial compared with blanket screening. However, subgroup analyses and long-term follow-up are still required.",{"name":119,"@type":110,"acceptedAnswer":120},"What mechanisms link H. pylori to cardiovascular events beyond GI bleeding?",{"text":121,"@type":113},"The text describes systemic inflammatory pathways that may induce endothelial dysfunction and a prothrombotic state. It also mentions virulent strains, metabolic risk profiles, and genetic evidence such as Mendelian randomization supporting a causal relationship.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},435574,1790811291,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":81,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":39,"preview_page_count":4},962090893057,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Editorial  \nShould H. pylori screening be integrated into MIcare protocols?  \nDua Zehra, MBBSa , Haris Afridi, MBBSb , Raghabendra Kumar Mahato, MBBSc ,*  \nAbstract  \nHelicobacter pylori is considered a modifiable and exacerbating risk factor in influencing post-myocardial infarction (MI) uppergastrointestinal (GI) bleeding, either due to antithrombotic therapies or other mechanisms. Numerous studies suggest highprevalence of H. pylori in post-MI patients, emphasizing the role of screening of H. pylori and timely introduction of eradicationtherapy in infected individual as a cost-effective strategy. H. pylori isnot only involved in post-MI bleeding but also play a role intriggering myocardial events and its recurrences through plaque destabilization, inflammatory response while its role indyslipi -demia remains inconsistent. This issue is under investigation since 2000 and had shown a significant relationship betweeninvolvement of H. pylori (especially CagAstrains) and MI, role of genetics and environmental factors in triggering H. pylori in MIpatients; however, most evidence up to date are either observational or cohort studies. Current randomized controlled trials (RCTs)suggest the role of targeted screening in high-risk population and area proved tobe beneficial than blanket screening. However,lack of subgroup analysis with RCTs and long-term follow-up is necessary to establish therole H. pylori screening in preventingrecurrent MI, reducing upper GI bleeding and cardiovascular outcomes. Furthermore, integrating inflammatory biomarkers andgenetic factors in screening might help in risk stratification.  \nThe management of post-myocardial infarction (MI) requires dualor triple antithrombotic therapy (aspirin and P2Y12 inhibitortherapy) to reduce recurrence of cardiovascular events,a treatment that inherently increases bleeding risk especiallyupper gastrointestinal (GI) bleeding. Current acute coronary syn -drome (ACS) guidelines, do not include Helicobacter pylori infec -tion despite its well-established role in increasing upper GIbleeding[1] . However, H. pylori infection is an independent andpotentially modifiable risk factor that exacerbates this bleedingrisk patients following MI, making its detection and potentialeradication clinically relevant. Although the incidence ofH. pylori in MI patients is relatively common, it varies consider -ably by region, with studies reporting rates from 20–24% up to88% . Its prevalence is high in people undergoing coronary angio -graphy as well [2] . A Swedish study found a seroprevalence of46.5%, while an Egyptian study reported 72%, with higher rates  \naDepartment of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan,bDepartment of Medicine, Gujranwala Medical College, Gujranwala, Pakistan andcDepartment of Medicine, Gandaki Medical College Teaching Hospital andResearch Centre, Pokhara, Nepal  \nSponsorships or competing interests that maybe relevant to content are disclosedatthe end of this article.  \n*Corresponding author. Address: Department of Medicine, Gandaki MedicalCollege Teaching Hospital and Research Centre, Pokhara 33700, Nepal.Tel.: +977 9745829807. E-mail: 102raghabendrakumarmahato@gmail.com(R.K. Mahato).  \nCopyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc. This is anopen access article distributed under the terms of the Creative CommonsAttribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where itispermissible to download and share the work provided itis properly cited. The workcannot be changed in any way or used commercially without permission from thejournal.  \nAnnals of Medicine & Surgery (2026) 88:51–53  \nReceived 20 November 2025; Accepted 24 November 2025Published online 9 December 2025http://dx.doi.org/10.1097/MS9.0000000000004514  \nobserved in smokers and ST-elevation MI patients. Despite thishigh prevalence, the role of routine H. pylori testing in post-MIcare remains a subject of underexplored and debated[3–5] .  \nThe g","cbCaioFczh9p8tF0","https://ap.wps.com/l/cbCaioFczh9p8tF0","pdf",206262,"English","# Background and clinical relevance\n## Pathophysiology and bleeding risk\n# Evidence and research gaps\n## Prevalence by region and study types\n## RCT evidence for targeted vs blanket screening\n# Future directions\n## Biomarkers, genetics, and long-term outcomes","[{\"question\":\"Why is H. pylori screening considered for post-myocardial infarction care?\",\"answer\":\"H. pylori infection is associated with an increased risk of post-MI upper gastrointestinal bleeding and may also contribute to ACS mechanisms. It is considered potentially modifiable, making detection and eradication clinically relevant.\"},{\"question\":\"Is universal (blanket) H. pylori screening supported by current trial evidence?\",\"answer\":\"Current randomized controlled trials suggest targeted screening in high-risk populations may be beneficial compared with blanket screening. However, subgroup analyses and long-term follow-up are still required.\"},{\"question\":\"What mechanisms link H. pylori to cardiovascular events beyond GI bleeding?\",\"answer\":\"The text describes systemic inflammatory pathways that may induce endothelial dysfunction and a prothrombotic state. It also mentions virulent strains, metabolic risk profiles, and genetic evidence such as Mendelian randomization supporting a causal relationship.\"}]","Should H. pylori screening be integrated into MIcare protocols? - Editorial | PDF",1790674254]