BACKGROUND: Previous studies suggested an association between CagA-positive H. 
pylori strains and ischemic stroke. The aim of the present study was to assess 
the prevalence of Helicobacter pylori infection and CagA status in patients with 
atherosclerotic stroke in the primary care setting.
MATERIALS AND METHODS: A total of 106 consecutive patients (age 76.6 +/- 8 
years; males 52%) with well-documented history of atherosclerotic stroke and 106 
sex-age- (age 76.5 +/- 9 years; males 52%) and social background-matched 
controls without relevant vascular diseases. Risk factors for ischemic stroke 
were recorded in all subjects. H. pylori infection was assessed by[13]C-urea 
breath test. A serologic assay for specific IgG against CagA was performed in 
infected subjects.
RESULTS: A trend toward a higher prevalence of H. pylori was observed in cases 
(63%) with respect to controls (54%) without reaching a statistical 
significance. CagA positivity was associated to a higher risk of atherosclerotic 
stroke (adjusted odds ratio 2.69, 95% confidence interval 1.37-5.30).
CONCLUSIONS: Our findings suggest that CagA-positive strains of H. pylori are 
significantly associated to atherosclerotic stroke. This is not a merely 
confirmative study since it has been performed for the first time in the primary 
care setting and included only subjects with an active infection.