Tuberculosis and increased risk of cardio-cerebrovascular disease: A nationwide cohort study.

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.