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Tuberculosis and increased risk of cardio-cerebrovascular disease: A nationwide cohort study
Se Ju Lee1, Jiwon Kim2, Haeyong Pak3
1Division of Infectious Diseases, Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea; Division of Infectious Diseases, Department of Internal Medicine, Inha University College of Medicine, Incheon, Republic of Korea.
Insights
Tuberculosis survivors face a significantly higher risk of developing cardio-cerebrovascular diseases (CVDs), including heart attack and stroke. This study highlights the need for targeted preventive strategies for individuals with a history of tuberculosis.
Area of Science:
- Cardiology
- Infectious Diseases
- Epidemiology
Background:
- Tuberculosis (TB) is a global health concern with potential long-term systemic effects.
- Emerging evidence suggests a link between TB infection and cardiovascular complications.
Purpose of the Study:
- To investigate the association between a history of tuberculosis (TB) and the incidence of cardio-cerebrovascular diseases (CVDs).
Main Methods:
- A population-based retrospective cohort study utilizing the National Health Insurance database in the Republic of Korea.
- Compared CVD incidence (myocardial infarction, arrhythmia, heart failure, cerebrovascular accident) in 70,458 TB survivors against 70,458 matched controls.
- Employed multivariable Cox proportional hazard models to analyze TB's association with CVD risk.
Main Results:
- TB survivors exhibited a higher incidence of overall CVD (5.9%) compared to controls (4.8%) over a mean follow-up of 70.2 months.
- TB was significantly associated with increased risks of overall CVD (aHR 1.305), myocardial infarction (aHR 1.245), arrhythmia (aHR 1.417), heart failure (aHR 1.666), and cerebrovascular accident (aHR 1.133).
Conclusions:
- Tuberculosis survivors demonstrate a substantially elevated risk for developing various cardio-cerebrovascular diseases.
- Proactive cardiovascular preventive measures are recommended for individuals with a history of tuberculosis to mitigate these risks.
Objectives:
To determine the association between tuberculosis (TB) and cardio-cerebrovascular diseases (CVDs).
Methods:
This population-based retrospective study used National Health Insurance database to compare CVD incidence, including myocardial infarction (MI), arrhythmia, heart failure, and cerebrovascular accident (CVA), between TB survivors and 1:1 age-, sex-, income-, region-, and registration date-matched controls in Republic of Korea. Cox proportional hazard models were used to analyze associations between CVDs and TB.
Results:
We assessed 70,458 individuals with TB and 70,458 matched controls. During a mean 70.2-month follow-up, CVD occurred in 4127 (5.9%) TB survivors and 3408 (4.8%) controls. The overall CVD incidence was 1035.24 and 801.46 per 100,000 person-years in the TB and control groups, respectively. Multivariable Cox proportional hazard analysis showed that TB was associated with a higher risk of overall CVD (adjusted hazard ratio [aHR] 1.305, 95% confidence interval [CI] 1.244-1.370), MI (aHR 1.245, 95% CI: 1.134-1.367), arrhythmia (aHR 1.417, 95% CI: 1.294-1.551), heart failure (aHR 1.666, 95% CI: 1.451-1.914), and CVA (aHR 1.133, 95% CI: 1.040-1.234) than matched controls.
Conclusion:
We observed a higher CVD risk in TB survivors than in matched controls. Our findings indicate that preventive measures against CVDs should be considered for this population.
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