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感染之外:在一项全国性队列研究中描绘恙虫病后心血管事件的风险

Beyond the infection: mapping the risk of cardiovascular events post-scrub typhus in a nationwide cohort study.

作者信息

Yeh Jih-Kai, Wu Victor Chien-Chia, Chen Shao-Wei, Wu Chia-Ling, Lin Yu-Sheng, Cheng Chun-Wen, Chang Chih-Hsiang, Wu Michael, Chu Pao-Hsien, Chang Shang-Hung, Huang Yu-Tung

机构信息

Division of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan.

Department of Cardiothoracic and Vascular Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan.

出版信息

Emerg Microbes Infect. 2025 Dec;14(1):2467766. doi: 10.1080/22221751.2025.2467766. Epub 2025 Feb 20.

Abstract

Scrub typhus, caused by , often involves multiple organs, but its cardiovascular (CV) sequelae in survivors remain under-researched. This retrospective cohort study analyzed data from the National Health Insurance Research Database (NHIRD) spanning 2010-2015 to assess CV risks among scrub typhus survivors. Excluding those with prior CV events, we focused on outcomes such as acute myocardial infarction (AMI), heart failure hospitalization (HFH), strokes, new-onset atrial fibrillation (AF), aortic aneurysm or dissection, venous thromboembolism (VTE), and CV death. From 2,269 scrub typhus patients without previous CV events (mean age 47.8 ± 16.1; 38.0% female), and a matched control group ( = 2,264), we observed a higher incidence of HFH, new-onset AF, and total CV events in the scrub typhus cohort. Adjusted hazard ratios (aHRs) were 1.97 (95% CI: 1.13-3.42) for HFH, 2.48 (95% CI: 1.23-5.0) for new-onset AF, and 1.43 (95% CI: 1.08-1.91) for total CV events. Other outcomes did not significantly differ. Scrub typhus survivors exhibit an increased risk of CV events, particularly HFH and new-onset AF, underscoring the importance of heightened physician awareness and post-infection cardiac surveillance.

摘要

恙虫病由[病原体未提及]引起,常累及多个器官,但幸存者的心血管(CV)后遗症仍研究不足。这项回顾性队列研究分析了2010 - 2015年国家健康保险研究数据库(NHIRD)的数据,以评估恙虫病幸存者的心血管风险。排除既往有心血管事件的患者后,我们重点关注急性心肌梗死(AMI)、心力衰竭住院(HFH)、中风、新发心房颤动(AF)、主动脉瘤或夹层、静脉血栓栓塞(VTE)和心血管死亡等结局。在2269例无既往心血管事件的恙虫病患者(平均年龄47.8±16.1岁;38.0%为女性)以及一个匹配的对照组(n = 2264)中,我们观察到恙虫病队列中HFH、新发AF和总心血管事件的发生率更高。HFH的调整后风险比(aHRs)为1.97(95%CI:1.13 - 3.42),新发AF为2.48(95%CI:1.23 - 5.0),总心血管事件为1.43(95%CI:1.08 - 1.91)。其他结局无显著差异。恙虫病幸存者发生心血管事件的风险增加,尤其是HFH和新发AF,这凸显了提高医生意识和感染后心脏监测的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a252/11843642/cb7adba8d829/TEMI_A_2467766_F0001_OB.jpg

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