We appreciate the interest by Jonatan Wärme and colleagues (Wärme, J. et al. Screening for Helicobacter pylori infection in patients with cardiovascular and gastrointestinal disease. Nat. Rev. Cardiol. https://doi.org/10.1038/s41569-024-01028-8, 2024)¹ in our Review (Talasaz, A. H. et al. Optimizing antithrombotic therapy in patients with coexisting cardiovascular and gastrointestinal disease. Nat. Rev. Cardiol. https://doi.org/10.1038/s41569-024-01003-3, 2024)². They propose that routine H. pylori screening and eradication might be a modifiable risk factor for gastrointestinal bleeding (GIB) in patients receiving antithrombotic agents. We find this hypothesis interesting and plausible but, for the reasons outlined below, we have reservations about consideration of H. pylori as an actionable treatment target to reduce the risk of bleeding in these patients.

我们感谢 Jonatan Wärme 及其同事的兴趣（Wärme, J. 等人。筛查心血管和胃肠道疾病患者的幽门螺杆菌感染。Nat . Rev. Cardiol。https ://doi.org/10.1038/s41569-024- 01028-8, 2024) ¹在我们的评论中（Talasaz, AH 等人。优化共存心血管和胃肠道疾病患者的抗血栓治疗。Nat . Rev. Cardiol 。 https://doi.org/10.1038/s41569-024-01003 -3, 2024) ² .他们提出，常规幽门螺杆菌筛查和根除可能是接受抗血栓药物治疗的患者胃肠道出血（GIB）的一个可改变的危险因素。我们发现这一假设有趣且合理，但由于下述原因，我们对将幽门螺杆菌作为降低这些患者出血风险的可行治疗目标持保留态度。