Yu X, Huang XY, Zhang XY, Sun YJ, Lu P, Cai SL, Zhang K. Letter to the Editor: Optimizing Helicobacter pylori eradication and cardiovascular risk assessment in long-term aspirin users: Methodological perspective. World J Gastroenterol 2026; 32(40): 123728 [DOI: 10.3748/wjg.123728]
Corresponding Author of This Article
Kai Zhang, MD, PhD, Associate Professor, Department of Gastroenterology, Endoscopic Center, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang 110004, Liaoning Province, China. zhangkaidoctor@163.com
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Gastroenterology & Hepatology
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letter
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Yu X, Huang XY, Zhang XY, Sun YJ, Lu P, Cai SL, Zhang K. Letter to the Editor: Optimizing Helicobacter pylori eradication and cardiovascular risk assessment in long-term aspirin users: Methodological perspective. World J Gastroenterol 2026; 32(40): 123728 [DOI: 10.3748/wjg.123728]
World J Gastroenterol. Oct 28, 2026; 32(40): 123728 Published online Oct 28, 2026. doi: 10.3748/wjg.123728
Letter to the Editor: Optimizing Helicobacter pylori eradication and cardiovascular risk assessment in long-term aspirin users: Methodological perspective
Xin Yu, Xing-Yong Huang, Xiao-Yue Zhang, Yi-Jia Sun, Kai Zhang, Department of Gastroenterology, Endoscopic Center, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Peng Lu, School of Life Sciences, Ludong University, Yantai 264025, Shandong Province, China
Shou-Liang Cai, Department of Thyroid and Breast Surgery, Ansteel General Hospital, Anshan 114002, Liaoning Province, China
Co-first authors: Xin Yu and Xing-Yong Huang.
Author contributions: Zhang K designed the overall concept, outlined the manuscript, and critically revised the manuscript for important intellectual content; Yu X and Huang XY drafted the manuscript and performed the comprehensive literature review as co-first authors; Zhang XY contributed to the clinical perspectives on cardiovascular outcomes and pathophysiological mechanisms; Sun YJ and Lu P provided critical insights into advanced endoscopic surveillance strategies; Cai SL contributed to the methodological assessment and data interpretation. All authors reviewed and approved the final version of the manuscript.
AI contribution statement: The authors assume full responsibility and accountability for the entirety of this manuscript, including portions where Doubao was used as a supporting technology for language refinement and text smoothing. All AI-assisted outputs were rigorously scrutinized, validated, and verified by the authors under strict human oversight. AI tools were not used to generate original scientific data, perform independent analyses, or draw scientific conclusions.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Kai Zhang, MD, PhD, Associate Professor, Department of Gastroenterology, Endoscopic Center, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang 110004, Liaoning Province, China. zhangkaidoctor@163.com
Received: May 28, 2026 Revised: July 13, 2026 Accepted: July 28, 2026 Published online: October 28, 2026 Processing time: 107 Days and 18.9 Hours
Abstract
This letter discusses the recent study by Semeya et al concerning Helicobacter pylori eradication and cardiovascular disease progression in chronic aspirin users. We commend the authors for their robust, real-world study design focusing on a complex cohort on multi-agent antithrombotic therapies, and for their detailed integration of histopathological classification. Based on their findings, we offer a constructive discussion on balancing the safety profiles of intensified eradication protocols in elderly recipients, particularly regarding renal impairment and drug-drug interactions. We also explore the specific pathophysiological pathways, such as virulent CagA-positive strain molecular mimicry and lipid metabolism disruptions, that drive secondary anti-inflammatory effects following infectious trigger removal. Lastly, we address the feasibility boundaries of advanced endoscopic surveillance, advocating for a targeted, risk-stratified paradigm to optimize long-term clinical outcomes in this vulnerable population.
Core Tip: Semeya et al provided exceptional real-world evidence of the benefits of Helicobacter pylori eradication for chronic aspirin users. To further upgrade this multidisciplinary clinical model, we discuss the safety boundaries of intensified alternative therapies in elderly patients and the specific pathophysiological cascades driving vascular stability. Rather than universal screening, we propose a highly targeted, risk-stratified surveillance approach utilizing advanced imaging to safely balance clinical justification with cost-effectiveness thresholds.
