Parameswaran Ganapathi I, Drye Alexandra F, Wattengel Bethany A, Carter Michael T, Doyle Kathleen M, Mergenhagen Kari A
Department of Infectious Diseases, Veterans Affairs Western New York Healthcare System, Buffalo, New York, USA.
Division of Infectious Diseases, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA.
Open Forum Infect Dis. 2023 Mar 25;10(4):ofad137. doi: 10.1093/ofid/ofad137. eCollection 2023 Apr.
Myocardial infarction (MI) has been reported as a postinfection sequela of herpes zoster, but with limited data on incidence after zoster and protective effect of the zoster vaccine. This study investigates the risk of developing an MI 30 days postzoster, determines patient-specific risk factors, and investigates the impact of herpes zoster vaccination.
This retrospective cohort study included patients who received care at a Veterans Affairs facility between 2015 and 2020. Time to MI was determined from either 30 days post-zoster infection (zoster cohort) or a primary care appointment (control cohort).
This study assessed a total of 2 165 584 patients. MI within 30 days occurred in 0.34% (n = 244) of the zoster cohort and 0.28% (n = 5782) of the control cohort ( = .0016). Patients with a documented herpes zoster infection during the study period were 1.35 times more likely to develop an MI within the first 30 days postinfection compared to the control cohort. Patients who received the recombinant zoster vaccine were less likely to have an MI postinfection (odds ratio, 0.82 [95% confidence interval, .74-.92]; = .0003).
Herpes zoster infection was associated with an increased risk of MI within the first 30 days postinfection. History of prior MI, male sex, age ≥50 years, history of heart failure, peripheral vascular disease, human immunodeficiency virus, prior cerebrovascular accident, and renal disease increased odds of MI 30 days postinfection with herpes zoster. Herpes zoster vaccination decreased the odds of developing an MI in patients aged ≥50 years.
心肌梗死（MI）已被报道为带状疱疹感染后的后遗症，但关于带状疱疹后发病率及带状疱疹疫苗保护作用的数据有限。本研究调查带状疱疹后30天发生心肌梗死的风险，确定患者特异性危险因素，并研究带状疱疹疫苗的影响。
这项回顾性队列研究纳入了2015年至2020年期间在退伍军人事务机构接受治疗的患者。从带状疱疹感染后30天（带状疱疹队列）或初级保健预约时间（对照队列）开始计算发生心肌梗死的时间。
本研究共评估了2165584例患者。带状疱疹队列中30天内发生心肌梗死的比例为0.34%（n = 244），对照队列中为0.28%（n = 5782）（P = 0.0016）。与对照队列相比，在研究期间有带状疱疹感染记录的患者在感染后的前30天内发生心肌梗死的可能性高1.35倍。接种重组带状疱疹疫苗的患者感染后发生心肌梗死的可能性较小（优势比，0.82[95%置信区间，0.74 - 0.92]；P = 0.0003）。
带状疱疹感染与感染后前30天内心肌梗死风险增加相关。既往心肌梗死病史、男性、年龄≥50岁、心力衰竭病史、外周血管疾病、人类免疫缺陷病毒、既往脑血管意外和肾病会增加带状疱疹感染后30天发生心肌梗死的几率。带状疱疹疫苗降低了≥50岁患者发生心肌梗死的几率。
