Sung-Han Kim, MD, PhD, a physician in the department of infectious diseases at Asan Medical Center in Seoul, Korea, and colleagues analyzed approximately 570,000 patients from a subset of the National Health Insurance Service database in Korea. Patients were stratified by whether they had herpes zoster, also known as shingles, and were followed up from 2002 to 2013.
Among those in the cohort, 4% contracted herpes zoster during the study period. Those with herpes zoster were matched with an individual without herpes zoster based on year of the study and numerous clinical and demographic characteristics (n = 23,213 in each group).
Compared with controls, those with herpes zoster were more likely to be older and female and to have hypertension, diabetes, dyslipidemia, angina pectoris, peripheral vascular disease, rheumatoid disease and malignancy. However, the herpes zoster group was less likely to smoke or consume alcohol, more likely to exercise regularly and more likely to be from a prosperous economic class, according to the researchers.
In the propensity-matched analysis, herpes zoster was associated with increased risk for a composite of CV events (HR = 1.41; 95% CI, 1.25-1.59), MI (HR = 1.59; 95% CI, 1.27-2.01) and stroke (HR = 1.35; 95% CI, 1.18-1.54), Kim and colleagues found.
The difference in stroke risk was most pronounced in individuals younger than 40 years, and decreased with age.
Among the herpes zoster cohort, risk for MI and stroke was highest in the first year after onset of herpes zoster and decreased over time, whereas risk was more evenly distributed over time in controls, Kim and colleagues wrote.
“While these findings require further study into the mechanism that causes shingles patients to have an increased risk [for MI] and stroke, it is important that physicians treating these patients make them aware of their increased risk,” Kim said in a press release. – by Erik Swain