| アブストラクト | BACKGROUND: Limited evidence suggests elevated risks of cardiovascular disease (CVD) among people diagnosed with tuberculosis (TB) disease, though studies have not adjusted for pre-existing CVD risk. We carried out a cohort study using two separate datasets, estimating CVD incidence in people with TB versus those without. METHODS: Using data from the United States (Veterans Health Administration) and the United Kingdom (Clinical Practice Research Datalink) for 2000-2020 we matched adults with incident TB disease and no CVD history 2-years before TB diagnosis (US n=2,121; UK n=15,820) with up to 10 people without TB on the basis of age, sex, race/ethnicity and healthcare practice. Participants were followed beginning 2-years before TB diagnosis and for 2-years subsequently. The acute period was defined as 3-months before/after TB diagnosis. TB, CVD and covariates were identified from electronic routinely collected data (primary and secondary care; mortality). Poisson models estimated incident rate ratios (IRR) for CVD events in people with TB compared to those without. RESULTS: CVD incidence was consistently higher in people with TB, including during the baseline period (pre-TB) and particularly in the acute period: IRRs were US 3.5 (95% Confidence Interval 2.7-4.4), UK 2.7 (2.2-3.3). Rate Ratios remained high after adjusting for differences in pre-existing CVD risk: US 3.2 (2.2-4.4), UK 1.6 (1.2-2.1). CONCLUSION: Increased CVD incidence was observed in people with TB versus those without, especially within months of TB diagnosis, persistent after adjustment for differences in pre-existing risk. Enhancing CVD screening and risk management may improve long-term outcomes in people with TB. |
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| ジャーナル名 | Clinical infectious diseases : an official publication of the Infectious Diseases Society of America |
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| Pubmed追加日 | 2024/11/4 |
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| 投稿者 | Critchley, Julia A; Limb, Elizabeth S; Khakharia, Anjali; Carey, Iain M; Auld, Sara C; DeWilde, Stephen; Harris, Tess; Phillips, Lawrence S; Cook, Derek G; Rhee, Mary K; Chaudhry, Umar A R; Bowen, Liza; Magee, Matthew J |
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| 組織名 | Population Health Research Institute, City St George's, University of London,;School of Health & Medical Sciences, Cranmer Terrace, London SW17 0RE, UK.;Atlanta VA Health Care System, Decatur, GA, USA.;Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of;Medicine, Emory School of Medicine, USA.;Departments of Global Health and Epidemiology, Rollins School of Public Health,;Emory University, 1518 Clifton Rd, NE Atlanta, GA 30322 USA.;Division of Endocrinology and Metabolism, Department of Medicine, Emory;University School of Medicine, USA. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/39495677/ |
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