Does Herpes Zoster Increase the Risk of Stroke and Myocardial Infarction? A Comprehensive Review.
Ping-Hsun WuYun-Shiuan ChuangYi-Ting LingPublished in: Journal of clinical medicine (2019)
Herpes zoster (HZ) caused by varicella zoster virus (VZV) reactivation is characterized as a vesicular rash of unilateral distribution that can also cause multiple complications; such as post-herpetic neuralgia; ophthalmic zoster; and other neurological issues. VZV can also increase incident hemorrhagic or ischemic complications by causing inflammatory vasculopathy. Thus; emerging epidemiological and clinical data recognizes an association between HZ and subsequent acute strokes or myocardial infarction (MI). This study reviewed published articles to elucidate the association between HZ and cerebrovascular and cardiac events. Individuals exposed to HZ or herpes zoster ophthalmicus had 1.3 to 4-fold increased risks of cerebrovascular events. Higher risks were noted among younger patients (age < 40 years) within one year after an HZ episode. The elevated risk of CV events diminished gradually according to age and length of time after an HZ episode. The putative mechanisms of VZV vasculopathy were also discussed. Several studies showed that the development of herpes zoster and herpes zoster ophthalmicus increased the risks of stroke; transient ischemic attack; and acute cardiac events. The association between VZV infection and cardiovascular events requires further studies to establish the optimal antiviral treatment and zoster vaccination to reduce zoster-associated vascular risk.
Keyphrases
- cardiovascular events
- left ventricular
- cerebral ischemia
- liver failure
- human health
- atrial fibrillation
- heart failure
- cardiovascular disease
- end stage renal disease
- respiratory failure
- coronary artery disease
- ejection fraction
- newly diagnosed
- risk factors
- drug induced
- randomized controlled trial
- chronic kidney disease
- electronic health record
- prognostic factors
- oxidative stress
- ischemia reperfusion injury
- case control
- risk assessment
- peritoneal dialysis
- machine learning
- climate change
- extracorporeal membrane oxygenation
- aortic dissection
- replacement therapy