Division of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, No. 5, Fuxing Street, Guishan District, Taoyuan City 33305, Taiwan.
College of Medicine, Chang Gung University, No. 259, Wenhua 1st Road, Guishan District, Taoyuan City 33302, Taiwan.
Eur Heart J. 2024 May 7;45(17):1512-1520. doi: 10.1093/eurheartj/ehae183.
Studies on the impact of syphilis on the cardiovascular system in large populations are limited. This study investigated the effects of syphilis on cardiovascular outcomes.
Medical records from 2010 to 2015 were retrieved from the Taiwan National Health Insurance Research Database, linked to the Notifiable Infectious Diseases database from the Taiwan Centers for Disease Control. Patients with syphilis were identified, excluding those with missing information, under 20 years of age, or with a history of human immunodeficiency virus infection, acute myocardial infarction, heart failure, aortic regurgitation, replacement of the aortic valve, aneurysm and/or dissection of the aorta, atrial fibrillation, ischaemic stroke, haemorrhagic stroke, and venous thromboembolism. Primary outcomes included new-onset acute myocardial infarction, heart failure, aortic regurgitation, aneurysm and dissection of the aorta, atrial fibrillation, ischaemic stroke, haemorrhagic stroke, venous thromboembolism, cardiovascular death, and all-cause mortality.
A total of 28 796 patients with syphilis were identified from 2010 to 2015. After exclusions and frequency matching, 20 601 syphilis patients and 20 601 non-syphilis patients were analysed. The relative rate (RR) was utilized in the analysis, as the competing risk of death was not considered. Compared with patients without syphilis, patients with syphilis had increased risks of acute myocardial infarction (RR 38%, 95% confidence interval [CI] 1.19-1.60, P < .001), heart failure (RR 88%, 95% CI 1.64-2.14, P < .001), aortic regurgitation (RR 81%, 95% CI 1.18-2.75, P = .006), atrial fibrillation (RR 45%, 95% CI 1.20-1.76, P < .001), ischaemic stroke (RR 68%, 95% CI 1.52-1.87, P < .001), haemorrhagic stroke (RR 114%, 95% CI 1.74-2.64, P < .001), venous thromboembolism (RR 67%, 95% CI 1.23-2.26, P = .001), cardiovascular death (RR 155%, 95% CI 2.11-3.08, P < .001), and all-cause death (RR 196%, 95% CI 2.74-3.19, P < .001) but not for aneurysm and dissection of the aorta.
This study demonstrates that patients with syphilis have a higher risk of cardiovascular events and all-cause mortality compared with those without syphilis.
关于梅毒对大人群心血管系统影响的研究有限。本研究旨在探讨梅毒对心血管结局的影响。
从 2010 年至 2015 年，我们从台湾全民健康保险研究数据库中提取了病历，并与台湾疾病管制中心传染病通报数据库进行了关联。我们确定了梅毒患者，但排除了信息缺失、年龄小于 20 岁或患有人类免疫缺陷病毒感染、急性心肌梗死、心力衰竭、主动脉瓣反流、主动脉瓣置换、主动脉瘤和/或夹层、心房颤动、缺血性中风、出血性中风以及静脉血栓栓塞的患者。主要结局包括新发急性心肌梗死、心力衰竭、主动脉瓣反流、主动脉瘤和夹层、心房颤动、缺血性中风、出血性中风、静脉血栓栓塞、心血管死亡和全因死亡。
我们从 2010 年至 2015 年共确定了 28796 例梅毒患者。排除和频数匹配后，分析了 20601 例梅毒患者和 20601 例非梅毒患者。由于未考虑死亡的竞争风险，因此使用相对风险（RR）进行分析。与无梅毒的患者相比，患有梅毒的患者发生急性心肌梗死（RR 38%，95%置信区间[CI] 1.19-1.60，P<.001）、心力衰竭（RR 88%，95%CI 1.64-2.14，P<.001）、主动脉瓣反流（RR 81%，95%CI 1.18-2.75，P=.006）、心房颤动（RR 45%，95%CI 1.20-1.76，P<.001）、缺血性中风（RR 68%，95%CI 1.52-1.87，P<.001）、出血性中风（RR 114%，95%CI 1.74-2.64，P<.001）、静脉血栓栓塞（RR 67%，95%CI 1.23-2.26，P=.001）、心血管死亡（RR 155%，95%CI 2.11-3.08，P<.001）和全因死亡（RR 196%，95%CI 2.74-3.19，P<.001）的风险更高，但主动脉瘤和夹层除外。
本研究表明，与无梅毒的患者相比，患有梅毒的患者发生心血管事件和全因死亡的风险更高。
