2017.07.21 08:21
This large retrospective cohort study used a subset of data from the Korean National Health Insurance Database to evaluate characteristics of patients newly diagnosed with stroke, myocardial infarction (MI), and herpes zoster (HZ) who were representative of the general population. A propensity score–matched analysis was performed to assess whether HZ affected risk of stroke and MI using data extracted from the records of 519,880 patients observed from 2003 to 2013. The HZ group differed from the non-HZ group in several ways, including containing a higher proportion of females, having more frequent association with risk factors for MI, and having lower rates of smoking, among other factors. The standardized differences for these factors were all <10% after propensity score matching and adjustment. A composite value including stroke, MI, and a composite of cardiovascular events was higher in those diagnosed with HZ compared with the non-HZ group. Risk of MI and stroke was greatest within the first year following HZ diagnosis and then declined. Hazard ratios for stroke decreased with age from a peak in individuals <40 years of age. The increase in risk associated with HZ infection was 59%, 41%, and 35% for MI, composite of cardiovascular events, and stroke, respectively, in propensity score–matched analysis.
These data suggest an important increase in the risk of cardiovascular events, stroke, and MI in patients with HZ, especially in the first year after infection and in younger patients lacking risk factors for atherosclerosis, suggesting a need for appropriate clinical monitoring of these patients.
This study within the Korean National Health Insurance Database followed approximately 23,000 patients newly diagnosed with herpes zoster (HZ) between 2002 and 2013, representing 4% of the entire cohort under observation. After propensity matching, patients with recent HZ were at 1.41 times higher risk (95% CI, 1.25–1.59) for the composite endpoint of cardiovascular (CV) events, including stroke (HR, 1.35) and myocardial infarction alone (HR, 1.59) within the first year after the onset of HZ. The risk was highest in the youngest group of patients, under 40 years of age (a relatively younger population with fewer risk factors for atherosclerosis). The association between HZ with subsequent CV events may be related to direct or indirect mechanisms of viral inflammation or other vascular injury–induced plaque rupture. Alternatively, younger patients susceptible to HZ may share common factors for higher risk of CV events (ie, a systemic illness). Nevertheless, if these compelling data are replicated, it might suggest that a randomized trial of varicella zoster virus vaccination for cardioprotection is warranted, similar to ongoing trials studying effective influenza vaccination.
2017.07.21 08:44
2017.07.21 08:56
It's been known or suspected that virus infection such as influenza predisposes one to CV events like
acute MI by making atherosclerotic plaques inflamed and unstable creating cracks and fissures
inducing thrombus.
As far as I know, Herpes Zoster has not been directly implicated until this original study from Korea.
No. | Subject | Date | Author | Last Update | Views |
---|---|---|---|---|---|
Notice | How to write your comments onto a webpage [2] | 2016.07.06 | 운영자 | 2016.11.20 | 18193 |
Notice | How to Upload Pictures in webpages | 2016.07.06 | 운영자 | 2018.10.19 | 32343 |
Notice | How to use Rich Text Editor [3] | 2016.06.28 | 운영자 | 2018.10.19 | 5920 |
Notice | How to Write a Webpage | 2016.06.28 | 운영자 | 2020.12.23 | 43838 |
8122 | Reunion with the Dead at Disneyland [2] | 2010.03.20 | 최원일*70 | 2010.03.20 | 7957 |
8121 | 발품팔이 [8] | 2010.03.21 | 황규정*65 | 2010.03.21 | 11346 |
8120 | 부고: 인정길*70 동문 모친상 [2] | 2010.03.21 | 최원일*70 | 2010.03.21 | 9071 |
8119 | Letter from Shin Dongwuk*70 [1] | 2010.03.21 | 최원일*70 | 2010.03.21 | 8339 |
8118 | Norway 여행 2008 (일정표) [5] | 2010.03.21 | 계기식*72 | 2010.03.21 | 7771 |
8117 | ♥ 급성관상동맥증후군(ACS)에서 관상동맥확장술(PCI)의 역할 | 2010.03.22 | 이종구*57 | 2010.03.22 | 7330 |
8116 | 노르웨이 9-1 (출발에서 발레쉬트란트 도착까지) [5] | 2010.03.22 | 계기식*72 | 2010.03.22 | 6904 |
8115 | 네 쌍둥이 자매와 이길여 이사장님 [5] | 2010.03.23 | SungjaCho#65 | 2010.03.23 | 7759 |
8114 | Obama Signs The HealthCare Reform Bill [15] | 2010.03.23 | 이한중*65 | 2010.03.23 | 3376 |
8113 | 노르웨이 9-2 (발레쉬트란트에서 베르겐까지) [5] | 2010.03.23 | 계기식*72 | 2010.03.23 | 7501 |
8112 | ♥ 소리 없는 살인자 고혈압 | 2010.03.24 | 이종구*57 | 2010.03.24 | 7378 |
8111 | 노르웨이 9-3 ( 베르겐 시내 관광 ) [5] | 2010.03.24 | 계기식*72 | 2010.03.24 | 7777 |
8110 | 韓美연합사 해체 이후의 한반도 시나리오 - 김필재 [2] | 2010.03.25 | 운영자 | 2010.03.25 | 7261 |
8109 | 韓國 현대사 성공을 北韓지역까지 확대해야 - 니시오카 츠토무 [4] | 2010.03.25 | 운영자 | 2010.03.25 | 7681 |
8108 | Letter from Convention Chair SNUCMAA 27: Lee, Sok Kyu*70 [2] | 2010.03.25 | 최원일*70 | 2010.03.25 | 9493 |
8107 | [추모] 박춘석 작곡/ 가요 감상 [5] | 2010.03.25 | 김명순*70음대 | 2010.03.25 | 9986 |
8106 | 노르웨이 9-4 ( Hardanger Fjord 관광 ) [2] | 2010.03.25 | 계기식*72 | 2010.03.25 | 8297 |
8105 | 노르웨이 9-5 ( Hurtigruten 연안 여객선) | 2010.03.26 | 계기식*72 | 2010.03.26 | 8482 |
8104 | Tea Party - who are they? [3] | 2010.03.26 | 이한중*65 | 2010.03.26 | 3390 |
8103 | 오늘밤 지구촌서 '불끄기 파도타기' [1] | 2010.03.27 | 황규정*65 | 2010.03.27 | 8755 |
Journal of the American College of Cardiology
Volume 70, Issue 2, July 2017DOI: 10.1016/j.jacc.2017.05.015
PDF Article
Herpes Zoster Increases the Risk of Stroke and Myocardial Infarction
Min-Chul Kim, Sung-Cheol Yun, Han-Bin Lee, Pil Hyung Lee, Seung-Whan Lee, Sang-Ho Choi, Yang Soo Kim, Jun Hee Woo, Sung-Han Kim, Sun U. Kwon
Of note, it is good to see an original study from Korea being published in a most reputable major journal, JACC,
which all the cardiologists of the world read regularly.