Division of Cardiology, Department of Internal Medicine, Taichung Tzu-Chi Buddhist General Hospital, Taichung, Taiwan; Graduate Institute of Clinical Medicine Science, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung, 404, Taiwan.
Br J Dermatol. 2014 May;170(5):1122-9. doi: 10.1111/bjd.12768.
Vasculopathy in varicella zoster virus (VZV) infection and a proposed association between herpes virus infection and atherosclerosis suggest a possible link between VZV infection and vascular thrombosis.
To determine the risk of acute coronary syndrome (ACS) associated with herpes zoster infection.
We used the Taiwan National Health Insurance Research Database to identify 57,958 patients newly diagnosed with herpes zoster between 1999 and 2010; 231,832 patients without herpes zoster were examined as the control group. Both cohorts were followed up until the end of 2010 to measure the incidence of ACS. Cox proportional-hazards regression and Kaplan-Meier analyses were used to measure the hazard ratios (HR) and the cumulative incidences of ACS, respectively.
The incidence of ACS was 1·24-fold higher in the herpes zoster group than in the control group [36·8 vs. 29·6 per 10,000 person-years, 95% confidence interval (CI) 1·16-1·33]. After adjusting for age, sex and comorbidities, the HR of ACS for the herpes zoster group compared with the control group was 1·15 (95% CI 1·07-1·24). Analysis by the time lag (≤ 3 months, ≤ 1 year, > 1 year) showed that the incidence of ACS remained significantly higher in the herpes zoster group than in the control group, with an adjusted HR of 1·10 (95% CI 1·02-1·19) after the 1-year follow-up period. The Kaplan-Meier survival curve showed that the risk of ACS was significantly higher in the herpes zoster group than in the control group (P < 0·001).
Herpes zoster infection is associated with an increased risk of ACS.
水痘-带状疱疹病毒（VZV）感染中的血管病变以及疱疹病毒感染与动脉粥样硬化之间的关联提示 VZV 感染与血管血栓形成之间可能存在联系。
确定带状疱疹感染与急性冠状动脉综合征（ACS）相关的风险。
我们使用台湾全民健康保险研究数据库，确定了 1999 年至 2010 年间 57958 例新诊断为带状疱疹的患者；选择 231832 例无带状疱疹的患者作为对照组。两组均随访至 2010 年底，以测量 ACS 的发生率。采用 Cox 比例风险回归和 Kaplan-Meier 分析分别测量风险比（HR）和 ACS 的累积发生率。
带状疱疹组 ACS 的发生率高于对照组（36.8 比 29.6/10000 人年，95%置信区间 1.16-1.33）。调整年龄、性别和合并症后，与对照组相比，带状疱疹组 ACS 的 HR 为 1.15（95%置信区间 1.07-1.24）。通过时间滞后（≤3 个月、≤1 年、>1 年）分析显示，在 1 年随访后，带状疱疹组 ACS 的发生率仍明显高于对照组，调整后的 HR 为 1.10（95%置信区间 1.02-1.19）。Kaplan-Meier 生存曲线显示，带状疱疹组 ACS 的风险明显高于对照组（P<0.001）。
带状疱疹感染与 ACS 风险增加相关。
