Herpes zoster and long-term vascular risk: a retrospective cohort study.
Amir HorevAnat HorevAdi Gordon-IrshaiMichal GordonNicolas AndreGal IferganePublished in: Scientific reports (2023)
Herpes zoster (HZ) represents a serious health problem in the general population due to its abundance and complications. Stroke and acute myocardial infarction are well-documented short-term complications of HZ, primarily due to vasculopathy in the cerebral and coronary arteries. However, no major study to date has specifically demonstrated that HZ is a long-term risk factor for all Major Adverse Cardiac and Cerebrovascular Events (MACCE). A retrospective cohort study was conducted analyzing the association between HZ and MACCE. We compared HZ patients diagnosed between 2001 and 2018 and a matched control group. The model was stratified according to matched pairs and adjusted for age, socioeconomic status, history of dyslipidemia, and prior myocardial infarction (MI). Association between HZ exposure and stroke was assessed through a multivariable Cox regression analysis. The study included 41,930 patients, with 20,965 patients in each group. The risk of MACCE was 19% higher among HZ patients in the first year of follow up (P < 0.001). Antiviral treatment did not positively affect long-term survival among HZ patients (P < 0.001). These results suggest that HZ is a marker of long-term vascular risk. Additional studies will be needed to further evaluate this risk, the impact of HZ vaccination on such risk, and potential mitigation strategies.
Keyphrases
- end stage renal disease
- newly diagnosed
- ejection fraction
- chronic kidney disease
- acute myocardial infarction
- healthcare
- peritoneal dialysis
- emergency department
- heart failure
- coronary artery disease
- mental health
- left ventricular
- patient reported outcomes
- risk assessment
- percutaneous coronary intervention
- climate change
- coronary artery
- microbial community
- brain injury
- social media
- blood brain barrier
- data analysis
- cerebral ischemia
- electronic health record