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Clin Infect Dis. 2018 Mar 5;66(6):886-892. doi: 10.1093/cid/cix910.

The Relationship Between Latent Tuberculosis Infection and Acute Myocardial Infarction.

Author information

1
Department of Internal Medicine, Division of Infectious Diseases, University of Cincinnati College of Medicine, Ohio.
2
Department of Medicine, Division of Infectious Diseases, University of Kentucky College of Medicine, Lexington.
3
Department of Infectious Diseases and Tropical Medicine, Hospital Nacional Dos de Mayo.
4
Department of Internal Medicine, Universidad Nacional Mayor de San Marcos.
5
Department of Cardiology, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru.
6
Departments of Biostatistics and Statistics, University of Kentucky Colleges of Public Health and Arts & Sciences, Lexington.
7
Department of Internal Medicine, Division of Infectious Diseases, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
8
Department of Medicine, Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, Tennessee.
9
Department of Microbiology, Immunology and Molecular Genetics, University of Kentucky College of Medicine, Lexington.

Abstract

Background:

Tuberculosis has been associated with an increased risk of cardiovascular disease (CVD), including acute myocardial infarction (AMI). We investigated whether latent tuberculosis infection (LTBI) is associated with AMI.

Methods:

We conducted a case-control study in 2 large national public hospital networks in Lima, Peru, between July 2015 and March 2017. Case patients were patients with a first time diagnosis of type 1 (spontaneous) AMI. Controls were patients without a history of AMI. We excluded patients with known human immunodeficiency virus infection, tuberculosis disease, or prior LTBI treatment. We used the QuantiFERON-TB Gold In-Tube assay to identify LTBI. We used logistic regression modeling to estimate the odds ratio (OR) of LTBI in AMI case patients versus non-AMI controls.

Results:

We enrolled 105 AMI case patients and 110 non-AMI controls during the study period. Overall, the median age was 62 years (interquartile range, 56-70 years); 69% of patients were male; 64% had hypertension, 40% dyslipidemia, and 39% diabetes mellitus; 30% used tobacco; and 24% were obese. AMI case patients were more likely than controls to be male (80% vs 59%; P < .01) and tobacco users (41% vs 20%; P < .01). LTBI was more frequent in AMI case patients than in controls (64% vs 49% [P = .03]; OR, 1.86; 95% confidence interval [CI], 1.08-3.22). After adjustment for age, sex, hypertension, dyslipidemia, diabetes mellitus, tobacco use, obesity, and family history of coronary artery disease, LTBI remained independently associated with AMI (adjusted OR, 1.90; 95% CI, 1.05-3.45).

Conclusions:

LTBI was independently associated with AMI. Our results suggest a potentially important role of LTBI in CVD.

PMID:
29069328
PMCID:
PMC5850031
[Available on 2019-03-05]
DOI:
10.1093/cid/cix910

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