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Herpes zoster infection associated with acute coronary syndrome: a population-based retrospective cohort study.
Br J Dermatol. 2014 May; 170(5):1122-9.BJ

Abstract

BACKGROUND

Vasculopathy in varicella zoster virus (VZV) infection and a proposed association between herpes virus infection and atherosclerosis suggest a possible link between VZV infection and vascular thrombosis.

OBJECTIVES

To determine the risk of acute coronary syndrome (ACS) associated with herpes zoster infection.

METHODS

We used the Taiwan National Health Insurance Research Database to identify 57,958 patients newly diagnosed with herpes zoster between 1999 and 2010; 231,832 patients without herpes zoster were examined as the control group. Both cohorts were followed up until the end of 2010 to measure the incidence of ACS. Cox proportional-hazards regression and Kaplan-Meier analyses were used to measure the hazard ratios (HR) and the cumulative incidences of ACS, respectively.

RESULTS

The incidence of ACS was 1·24-fold higher in the herpes zoster group than in the control group [36·8 vs. 29·6 per 10,000 person-years, 95% confidence interval (CI) 1·16-1·33]. After adjusting for age, sex and comorbidities, the HR of ACS for the herpes zoster group compared with the control group was 1·15 (95% CI 1·07-1·24). Analysis by the time lag (≤ 3 months, ≤ 1 year, > 1 year) showed that the incidence of ACS remained significantly higher in the herpes zoster group than in the control group, with an adjusted HR of 1·10 (95% CI 1·02-1·19) after the 1-year follow-up period. The Kaplan-Meier survival curve showed that the risk of ACS was significantly higher in the herpes zoster group than in the control group (P < 0·001).

CONCLUSION

Herpes zoster infection is associated with an increased risk of ACS.

Authors+Show Affiliations

Division of Cardiology, Department of Internal Medicine, Taichung Tzu-Chi Buddhist General Hospital, Taichung, Taiwan; Graduate Institute of Clinical Medicine Science, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung, 404, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24354564

Citation

Wang, C-C, et al. "Herpes Zoster Infection Associated With Acute Coronary Syndrome: a Population-based Retrospective Cohort Study." The British Journal of Dermatology, vol. 170, no. 5, 2014, pp. 1122-9.
Wang CC, Lin CL, Chang YJ, et al. Herpes zoster infection associated with acute coronary syndrome: a population-based retrospective cohort study. Br J Dermatol. 2014;170(5):1122-9.
Wang, C. C., Lin, C. L., Chang, Y. J., Wang, G. J., Sung, F. C., & Kao, C. H. (2014). Herpes zoster infection associated with acute coronary syndrome: a population-based retrospective cohort study. The British Journal of Dermatology, 170(5), 1122-9. https://doi.org/10.1111/bjd.12768
Wang CC, et al. Herpes Zoster Infection Associated With Acute Coronary Syndrome: a Population-based Retrospective Cohort Study. Br J Dermatol. 2014;170(5):1122-9. PubMed PMID: 24354564.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Herpes zoster infection associated with acute coronary syndrome: a population-based retrospective cohort study. AU - Wang,C-C, AU - Lin,C-L, AU - Chang,Y-J, AU - Wang,G-J, AU - Sung,F-C, AU - Kao,C-H, PY - 2013/12/01/accepted PY - 2013/12/21/entrez PY - 2013/12/21/pubmed PY - 2015/1/13/medline SP - 1122 EP - 9 JF - The British journal of dermatology JO - Br. J. Dermatol. VL - 170 IS - 5 N2 - BACKGROUND: Vasculopathy in varicella zoster virus (VZV) infection and a proposed association between herpes virus infection and atherosclerosis suggest a possible link between VZV infection and vascular thrombosis. OBJECTIVES: To determine the risk of acute coronary syndrome (ACS) associated with herpes zoster infection. METHODS: We used the Taiwan National Health Insurance Research Database to identify 57,958 patients newly diagnosed with herpes zoster between 1999 and 2010; 231,832 patients without herpes zoster were examined as the control group. Both cohorts were followed up until the end of 2010 to measure the incidence of ACS. Cox proportional-hazards regression and Kaplan-Meier analyses were used to measure the hazard ratios (HR) and the cumulative incidences of ACS, respectively. RESULTS: The incidence of ACS was 1·24-fold higher in the herpes zoster group than in the control group [36·8 vs. 29·6 per 10,000 person-years, 95% confidence interval (CI) 1·16-1·33]. After adjusting for age, sex and comorbidities, the HR of ACS for the herpes zoster group compared with the control group was 1·15 (95% CI 1·07-1·24). Analysis by the time lag (≤ 3 months, ≤ 1 year, > 1 year) showed that the incidence of ACS remained significantly higher in the herpes zoster group than in the control group, with an adjusted HR of 1·10 (95% CI 1·02-1·19) after the 1-year follow-up period. The Kaplan-Meier survival curve showed that the risk of ACS was significantly higher in the herpes zoster group than in the control group (P < 0·001). CONCLUSION: Herpes zoster infection is associated with an increased risk of ACS. SN - 1365-2133 UR - https://www.unboundmedicine.com/medline/citation/24354564/Herpes_zoster_infection_associated_with_acute_coronary_syndrome:_a_population_based_retrospective_cohort_study_ L2 - https://doi.org/10.1111/bjd.12768 DB - PRIME DP - Unbound Medicine ER -