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

Abstract

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 10 0,0 0 0 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. (c) 2025 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)