Özden Y. Letter to the Editor: Helicobacter pylori eradication in aspirin users - gastroprotection established, cardiovascular implications to be clarified. World J Gastroenterol 2026; 32(35): 120142 [DOI: 10.3748/wjg.120142]
Corresponding Author of This Article
Yavuz Özden, MD, Department of Gastroenterology, Kayseri City Hospital, University of Health Sciences, Şeker District, Muhsin Yazıcıoğlu Boulevard No. 77 Kocasinan, Kayseri 38080, Türkiye. yavuzozden@gmail.com
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Gastroenterology & Hepatology
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letter
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Özden Y. Letter to the Editor: Helicobacter pylori eradication in aspirin users - gastroprotection established, cardiovascular implications to be clarified. World J Gastroenterol 2026; 32(35): 120142 [DOI: 10.3748/wjg.120142]
World J Gastroenterol. Sep 21, 2026; 32(35): 120142 Published online Sep 21, 2026. doi: 10.3748/wjg.120142
Letter to the Editor: Helicobacter pylori eradication in aspirin users - gastroprotection established, cardiovascular implications to be clarified
Yavuz Özden
Yavuz Özden, Department of Gastroenterology, Kayseri City Hospital, University of Health Sciences, Kayseri 38080, Türkiye
Author contributions: Özden Y conceived and wrote this letter, and approved the final version to publish.
AI contribution statement: This manuscript did not use any artificial intelligence tool to generate its scientific content, interpretations, arguments, or conclusions. Artificial intelligence-assisted language tools were used only to a limited extent for language and fluency refinement. No artificial intelligence tool was used in the design of the study, interpretation of the literature, or data analysis. The author critically reviewed and approved the final version of the manuscript and takes full responsibility for its content.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Yavuz Özden, MD, Department of Gastroenterology, Kayseri City Hospital, University of Health Sciences, Şeker District, Muhsin Yazıcıoğlu Boulevard No. 77 Kocasinan, Kayseri 38080, Türkiye. yavuzozden@gmail.com
Received: February 27, 2026 Revised: March 10, 2026 Accepted: May 20, 2026 Published online: September 21, 2026 Processing time: 183 Days and 22.8 Hours
Abstract
Semeya et al recently published a study in the World Journal of Gastroenterology reported that Helicobacter pylori eradication in chronic low-dose aspirin users was associated with a marked reduction in peptic ulcer bleeding and with less cardiovascular disease progression. The gastrointestinal benefit appears clinically important and is consistent with previous evidence supporting testing and eradication strategies in selected high-risk aspirin users. However, the cardiovascular findings should be interpreted with caution because the composite outcome did not consist exclusively of hard atherosclerotic endpoints, the follow-up period was relatively short, and residual confounding cannot be fully excluded. In addition, the modest eradication rate with levofloxacin-based therapy and the heterogeneity of concomitant antithrombotic treatment may have influenced the observed associations. Further prospective studies with longer follow-up and hard cardiovascular outcomes are needed to clarify whether eradication provides true cardiovascular benefit beyond gastrointestinal protection.
Core Tip: Helicobacter pylori eradication in chronic aspirin users appears to provide meaningful gastrointestinal protection and may reduce peptic ulcer bleeding risk. However, the reported cardiovascular benefit should be interpreted cautiously because of short follow-up, composite endpoint selection, possible residual confounding, and modest eradication success. Future studies should focus on optimized eradication strategies and hard cardiovascular outcomes.
