Department of Family Medicine and Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (H.R.L., D.W.S.).
Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Republic of Korea (J.E.Y.).
Stroke. 2022 Nov;53(11):3401-3409. doi: 10.1161/STROKEAHA.122.039484. Epub 2022 Aug 30.
Conflicting results exist regarding the risk of ischemic stroke in tuberculosis survivors. We aimed to estimate the risk of ischemic stroke using a nationwide population-based retrospective cohort.
We gathered data from the Korean National Health Insurance Service on tuberculosis survivors and 1:1 age- and sex-matched non-tuberculosis cases. Eligible participants were followed up from 1 year after tuberculosis diagnosis to the date of ischemic stroke event, date of death, or until the end of the study period (December 31, 2018), whichever came first. Cox proportional hazard regression and stratified analyses were performed to identify any related factors.
During follow-up periods of 3.8 years for patients with tuberculosis and matched non-tuberculosis cases, 1.3% of patients with tuberculosis (941/72 863) and 1.0% of matched non-tuberculosis cases (707/72 863) developed ischemic stroke. The overall risk of ischemic stroke was higher in tuberculosis patients (adjusted hazard ratio: 1.22 [95% CI, 1.10-1.36]) compared with the matched non-tuberculosis cases. A stratified analysis showed that patients with tuberculosis had increased risk of ischemic stroke regardless of age, sex, smoking status, alcohol consumption, physical activity, body mass index, and Charlson Comorbidity Index score.
Tuberculosis survivors had a higher risk of ischemic stroke than their matched non-tuberculosis cases. The results of this study suggest that tuberculosis is a crucial infectious factor associated with increased incidence of ischemic stroke.
结核病幸存者发生缺血性卒中的风险存在争议。我们旨在使用全国基于人群的回顾性队列来估计缺血性卒中的风险。
我们从韩国国家健康保险服务中收集了结核病幸存者和 1:1 年龄和性别匹配的非结核病病例的数据。合格的参与者从结核病诊断后 1 年开始随访，直至发生缺血性卒中事件、死亡日期或研究期结束（2018 年 12 月 31 日），以先到者为准。进行 Cox 比例风险回归和分层分析以确定相关因素。
在结核病患者和匹配的非结核病病例的 3.8 年随访期间，1.3%的结核病患者（941/72863）和 1.0%的匹配非结核病病例（707/72863）发生缺血性卒中。与匹配的非结核病病例相比，结核病患者整体缺血性卒中风险更高（调整后的危险比：1.22[95%CI，1.10-1.36]）。分层分析显示，无论年龄、性别、吸烟状况、饮酒状况、身体活动、体重指数和 Charlson 合并症指数评分如何，结核病患者发生缺血性卒中的风险均增加。
结核病幸存者发生缺血性卒中的风险高于其匹配的非结核病病例。本研究结果表明，结核病是与缺血性卒中发病率增加相关的重要感染因素。
