Tuberculosis and the risk of ischemic stroke: a 3-year follow-up study.
OBJECTIVE
The aim of this study is to estimate the risk of ischemic stroke during a 3-year follow-up period after a tuberculosis diagnosis using a nationwide, population-based study and a retrospective cohort design.


METHODS
The study cohort comprised 2283 patients who had received treatment for tuberculosis, except tuberculosis of the meninges and central nervous system, between 2000 and 2003; 6849 randomly selected subjects comprised the comparison cohort. Cox proportional hazard regressions were performed as a means of comparing the 3-year ischemic stroke-free survival rate between these 2 cohorts.


RESULTS
Of the 9132 sampled patients, 392 (4.3%) experienced ischemic stroke during the 3-year follow-up period, including 136 (6.0% of the tuberculosis patients) from the study cohort and 256 (3.7%) from the comparison cohort. After adjusting for patient age, gender, hypertension, diabetes, coronary heart disease, hyperlipidemia, malignancy, monthly income, and the geographical region and urbanization level of the community in which the patient resided, the hazard ratio of ischemic stroke for tuberculosis patients was 1.52-times (95% CI, 1.21-1.91; P<0.001) higher than for comparison patients.


CONCLUSIONS
We conclude that patients with a tuberculosis diagnosis are at an increased risk for ischemic stroke but not hemorrhagic stroke in the next 3 years. Further research is necessary to investigate these findings in tuberculosis-endemic areas.
Sheu
Jau-Jiuan
JJ
Department of Neurology, Taipei Medical University Hospital, Taipei, Taiwan.
Chiou
Hung-Yi
HY
Kang
Jiunn-Horng
JH
Chen
Yi-Hua
YH
Lin
Herng-Ching
HC
D000328:Adult; D000368:Aged; D002545:Brain Ischemia / Q000453:epidemiology*; D002543:Cerebral Hemorrhage / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D014376:Tuberculosis / Q000453:epidemiology*