The Relationship Between Latent Tuberculosis Infection and Acute Myocardial Infarction

Abstract

Background

Tuberculosis has been associated with an increased risk of cardiovascular disease (CVD), including acute myocardial infarction (AMI). We investigated whether latent tuberculosis infection (LTBI) is associated with AMI.

Methods

We conducted a case-control study in 2 large national public hospital networks in Lima, Peru, between July 2015 and March 2017. Case patients were patients with a first time diagnosis of type 1 (spontaneous) AMI. Controls were patients without a history of AMI. We excluded patients with known human immunodeficiency virus infection, tuberculosis disease, or prior LTBI treatment. We used the QuantiFERON-TB Gold In-Tube assay to identify LTBI. We used logistic regression modeling to estimate the odds ratio (OR) of LTBI in AMI case patients versus non-AMI controls.

Results

We enrolled 105 AMI case patients and 110 non-AMI controls during the study period. Overall, the median age was 62 years (interquartile range, 56–70 years); 69% of patients were male; 64% had hypertension, 40% dyslipidemia, and 39% diabetes mellitus; 30% used tobacco; and 24% were obese. AMI case patients were more likely than controls to be male (80% vs 59%; P < .01) and tobacco users (41% vs 20%; P < .01). LTBI was more frequent in AMI case patients than in controls (64% vs 49% [P = .03]; OR, 1.86; 95% confidence interval [CI], 1.08–3.22). After adjustment for age, sex, hypertension, dyslipidemia, diabetes mellitus, tobacco use, obesity, and family history of coronary artery disease, LTBI remained independently associated with AMI (adjusted OR, 1.90; 95% CI, 1.05–3.45).

Conclusions

LTBI was independently associated with AMI. Our results suggest a potentially important role of LTBI in CVD.

Document Type

Article

Publication Date

3-15-2018

Notes/Citation Information

Published in Clinical Infectious Diseases, v. 66, issue 6, p. 886-892.

© The Author(s) 2017

Digital Object Identifier (DOI)

https://doi.org/10.1093/cid/cix910

Funding Information

This work was supported in part by the University of Cincinnati Department of Internal Medicine (Junior Faculty Pilot Award) and the National Center for Research Resources and National Center for Advancing Translational Sciences, National Institutes of Health (grant UL1TR000117 to the University of Kentucky Center for Clinical and Translational Science).

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