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Syphilis and cardiovascular risk: a Taiwanese registry
Victor Chien-Chia Wu1,2, Jih-Kai Yeh1, Shao-Wei Chen3,4
1Division of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, No. 5, Fuxing Street, Guishan District, Taoyuan City 33305, Taiwan.
Insights
Syphilis significantly increases the risk of cardiovascular events, including heart attack and stroke. Patients with syphilis face a higher likelihood of cardiovascular death and overall mortality compared to those without the infection.
Area of Science:
- Cardiovascular Medicine
- Infectious Diseases
- Epidemiology
Background:
- Limited research exists on syphilis's cardiovascular impact in large populations.
- This study addresses the gap by investigating cardiovascular outcomes in syphilis patients.
Purpose of the Study:
- To determine the association between syphilis infection and cardiovascular disease risk.
- To quantify the increased risk of various cardiovascular events and mortality in syphilis patients.
Main Methods:
- Utilized Taiwan's National Health Insurance Research Database (2010-2015) linked with infectious disease data.
- Included 20,601 syphilis patients and 20,601 matched controls, excluding specific pre-existing conditions.
- Analyzed primary outcomes including myocardial infarction, heart failure, stroke, and mortality.
Main Results:
- Syphilis patients showed significantly higher risks for acute myocardial infarction, heart failure, aortic regurgitation, atrial fibrillation, ischemic and hemorrhagic stroke, and venous thromboembolism.
- A notable increase in cardiovascular death (RR 155%) and all-cause mortality (RR 196%) was observed in syphilis patients.
- No increased risk was found for aortic aneurysm or dissection.
Conclusions:
- Syphilis infection is associated with a substantially elevated risk of cardiovascular events.
- Patients diagnosed with syphilis have a significantly higher risk of both cardiovascular and all-cause mortality.
Background And Aims:
Studies on the impact of syphilis on the cardiovascular system in large populations are limited. This study investigated the effects of syphilis on cardiovascular outcomes.
Methods:
Medical records from 2010 to 2015 were retrieved from the Taiwan National Health Insurance Research Database, linked to the Notifiable Infectious Diseases database from the Taiwan Centers for Disease Control. Patients with syphilis were identified, excluding those with missing information, under 20 years of age, or with a history of human immunodeficiency virus infection, acute myocardial infarction, heart failure, aortic regurgitation, replacement of the aortic valve, aneurysm and/or dissection of the aorta, atrial fibrillation, ischaemic stroke, haemorrhagic stroke, and venous thromboembolism. Primary outcomes included new-onset acute myocardial infarction, heart failure, aortic regurgitation, aneurysm and dissection of the aorta, atrial fibrillation, ischaemic stroke, haemorrhagic stroke, venous thromboembolism, cardiovascular death, and all-cause mortality.
Results:
A total of 28 796 patients with syphilis were identified from 2010 to 2015. After exclusions and frequency matching, 20 601 syphilis patients and 20 601 non-syphilis patients were analysed. The relative rate (RR) was utilized in the analysis, as the competing risk of death was not considered. Compared with patients without syphilis, patients with syphilis had increased risks of acute myocardial infarction (RR 38%, 95% confidence interval [CI] 1.19-1.60, P < .001), heart failure (RR 88%, 95% CI 1.64-2.14, P < .001), aortic regurgitation (RR 81%, 95% CI 1.18-2.75, P = .006), atrial fibrillation (RR 45%, 95% CI 1.20-1.76, P < .001), ischaemic stroke (RR 68%, 95% CI 1.52-1.87, P < .001), haemorrhagic stroke (RR 114%, 95% CI 1.74-2.64, P < .001), venous thromboembolism (RR 67%, 95% CI 1.23-2.26, P = .001), cardiovascular death (RR 155%, 95% CI 2.11-3.08, P < .001), and all-cause death (RR 196%, 95% CI 2.74-3.19, P < .001) but not for aneurysm and dissection of the aorta.
Conclusions:
This study demonstrates that patients with syphilis have a higher risk of cardiovascular events and all-cause mortality compared with those without syphilis.
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