title: Tuberculosis and risk of acute myocardial infarction: a propensity score-matched analysis.
abstract: Several pathogens have been associated with increased cardiovascular disease (CVD) risk. Whether this occurs with Mycobacterium tuberculosis infection is unclear. We assessed if tuberculosis disease increased the risk of acute myocardial infarction (AMI). We identified patients with tuberculosis index claims from a large de-identified database of ~15 million adults enrolled in a U.S. commercial insurance policy between 2008 and 2010. Tuberculosis patients were 1:1 matched to patients without tuberculosis claims using propensity scores. We compared the occurrence of index AMI claims between the tuberculosis and non-tuberculosis cohorts using Kaplan-Meier curves and Cox Proportional Hazard models. Data on 2026 patients with tuberculosis and 2026 propensity-matched patients without tuberculosis were included. AMI was more frequent in the tuberculosis cohort compared with the non-tuberculosis cohort, 67 (3·3%) vs. 32 (1·6%) AMI cases, respectively, P < 0·01. Tuberculosis was associated with an increased risk of AMI (adjusted hazard ratio (HR) 1·98, 95% confidence intervals (CI) 1·3-3·0). The results were similar when the analysis was restricted to pulmonary tuberculosis (adjusted HR 2·43, 95% CI 1·5-4·1). Tuberculosis was associated with an increased risk of AMI. CVD risk assessment should be considered in tuberculosis patients. Mechanistic studies of tuberculosis and CVD are warranted.
authors.affiliation: Department of Internal Medicine,University of Cincinnati College of Medicine,Cincinnati, OH,USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Huaman
authors.affiliation: Departments of Biostatistics and Statistics,University of Kentucky College of Public Health,Lexington, KY,USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Kryscio
authors.affiliation: Department of Internal Medicine,University of Cincinnati College of Medicine,Cincinnati, OH,USA.
authors.forename: C J
authors.initials: CJ
authors.lastname: Fichtenbaum
authors.affiliation: Department of Medicine,University of Kentucky College of Medicine,Lexington, KY,USA.
authors.forename: D
authors.initials: D
authors.lastname: Henson
authors.affiliation: University of Kentucky College of Nursing,Lexington, KY,USA.
authors.forename: E
authors.initials: E
authors.lastname: Salt
authors.affiliation: Department of Medicine,Vanderbilt University School of Medicine,Nashville, TN,USA.
authors.forename: T R
authors.initials: TR
authors.lastname: Sterling
authors.affiliation: Department of Medicine,University of Kentucky College of Medicine,Lexington, KY,USA.
authors.forename: B A
authors.initials: BA
authors.lastname: Garvy
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000382:microbiology*; D015995:Prevalence; D057216:Propensity Score; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D014376:Tuberculosis / Q000150:complications* / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology
keywords: Acute myocardial infarction; cardiovascular disease; risk; tuberculosis