Vaccination, antiviral treatment fails to affect stroke risk from herpes zoster(Shingles)

You'll have to ask your doctor what this means and whether you should get the more advanced vaccine from 2017. 

Vaccination, antiviral treatment fails to affect stroke risk from herpes zoster(Shingles)

Contracting herpes zoster increased risk for acute ischemic stroke, and among patients with herpes zoster, vaccination or antiviral treatment did not modify the risk, according to data presented at the International Stroke Conference.
Previous studies had shown that herpes zoster increases risk for acute ischemic stroke, but none had evaluated the effect of vaccination or antiviral treatment after herpes zoster infection on stroke risk, Quanhe Yang, PhD, senior scientist with the epidemiology and surveillance branch in the CDC’s Division for Heart Disease and Stroke Prevention, and colleagues wrote in an abstract.

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The researchers analyzed 35,186 Medicare fee-for-service beneficiaries who were diagnosed with herpes zoster and acute ischemic stroke between 2007 and 2015.
Participants were stratified into four groups: those with no vaccination or antiviral treatment (49%), those with vaccination but no antiviral treatment (9%), those with antiviral treatment but no vaccination (34%) and those with both vaccination and antiviral treatment (8%).
Incident rate ratios for acute ischemic stroke were 1.61 (95% CI, 1.51-1.7) at 0 to 14 days, 1.35 (95% CI, 1.27-1.44) at 15 to 30 days, 1.16 (95% CI, 1.12-1.2) at 31 to 90 days, and 1.05 (95% CI, 1.02-1.08) at 91 to 180 days, according to the researchers.
Yang and colleagues found no effect modification due to vaccination or antiviral treatment (P for interaction = .6) after onset of herpes zoster. They also found the results were consistent regardless of race/ethnicity and sex.
“Risk of [acute ischemic stroke] increased significantly following [herpes zoster], and this increased risk didn’t appear to be modified by [herpes zoster] vaccination and antiviral treatment following [herpes zoster],” Yang and colleagues wrote in the abstract. “Primary prevention of [herpes zoster] by [herpes zoster] vaccination might be the most effective approach to prevent [herpes zoster]-associated [acute ischemic stroke].” – by Erik Swain
Reference:
Yang Q, et al. Abstract 39. Presented at: International Stroke Conference; Feb. 5-8, 2019; Honolulu.

Herpes zoster(shingles) linked to elevated risk for MI, stroke

My insurance wouldn't pay for the vaccine until after age 60 so your doctor will need to battle the insurance bastards for approval and payment.  But I bet they will pay for your heart attack or stroke.
https://www.healio.com/cardiology/vascular-medicine/news/online/%7B4f5bdf37-146b-4f48-9917-fc00ca38b9db%7D/herpes-zoster-linked-to-elevated-risk-for-mi-stroke?utm_source=selligent&utm_medium=email&utm_campaign=cardiology%20news&m_bt=592835816269

Kim MC, et al. J Am Coll Cardiol. 2017;doi:10.1016/j.jacc.2017.05.015.

July 3, 2017

Adults who contract herpes zoster are at elevated risk for MI and stroke, even after adjustment for confounding factors, according to a research letter published in the Journal of the American College of Cardiology.
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.

See Also

• Herpes zoster infection increases risk for stroke, TIA
• Herpes zoster increased stroke risk
• Herpes zoster increased risk for stroke, TIA, MI in young...

Kim and colleagues conducted a propensity score-matched analysis to determine whether herpes zoster was linked to risk for MI or stroke.
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

Herpes Zoster and the Risk of Stroke in Patients with Autoimmune Diseases - CME

Not how to get survivors 100% recovered but another risk for stroke, probably with nothing even suggested to ameliorate that risk.

Credit: 0.50 CME Cleveland Clinic Center for Continuing Education Herpes Zoster and the Risk of Stroke in Patients with Autoimmune Diseases

Risk of Stroke and Myocardial Infarction After Herpes Zoster(Shingles) in Older Adults in a US Community Population

I just got the vaccine which is 51% effective so maybe I'm good.
http://www.ncbi.nlm.nih.gov/pubmed/26704438

Yawn BP¹, Wollan PC², Nagel MA³, Gilden D⁴.

Author information

Abstract

OBJECTIVE:

To assess the risk of stroke and myocardial infarction (MI) after herpes zoster in a US community population of older adults.

PATIENTS AND METHODS:

We performed a community cohort study (January 1, 1986, to October 1, 2011) comparing the risk of stroke and MI in 4862 adult residents of Olmsted County, Minnesota, 50 years and older with and without herpes zoster and 19,433 sex- and age-matched individuals with no history of herpes zoster. Odds ratios are presented for MI and stroke at 3, 6, 12, and 36 months after index herpes zoster plus hazard ratios for long-term risk (up to 28.6 years).

RESULTS:

Individuals with herpes zoster had more risk or confounding factors for MI and stroke, suggesting that they had worse health status overall. When controlling for the multiple risk factors, those with herpes zoster were at increased risk for stroke at 3 months after herpes zoster compared with those without a history of herpes zoster (odds ratio, 1.53; 95% CI, 1.10-2.33; P=.04). The association between herpes zoster and MI at 3 months was not robust across analytic methods. Herpes zoster was not associated with an increased risk of stroke or MI at any point beyond 3 months.

CONCLUSIONS:

Herpes zoster was associated with only a short-term increased risk of stroke, which may be preventable with the prevention of herpes zoster.
Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

PMID:

26704438

PMCID:

PMC4856435

[Available on 2017-01-01]

DOI:

10.1016/j.mayocp.2015.09.015

[PubMed - indexed for MEDLINE]

Statins and the risk of herpes zoster: A population-based cohort study

I have no clue if this is alarming or not. Ask your up-to-date doctor for clarification on whether you should worry about this.
http://cid.oxfordjournals.org/content/early/2013/12/02/cid.cit745.short?rss=1

1. Tony Antoniou1,2,3,4,
2. Hong Zheng4,
3. Samantha Singh4,
4. David N. Juurlink3,4,5,
5. Muhammad M. Mamdani2,3,4,6,7, and
6. Tara Gomes2,3,4,6

+ Author Affiliations

1. ¹Department of Family and Community Medicine, St Michael's Hospital
2. ²Keenan Research Centre of the Li Ka Shing Knowledge Institute, St Michael's Hospital
3. ³University of Toronto
4. ⁴Institute for Clinical Evaluative Sciences
5. ⁵Sunnybrook Research Institute
6. ⁶Applied Health Research Centre, St Michael's Hospital, Toronto, Ontario, Canada
7. ⁷King Saud University, Riyadh, Saudi Arabia

1. Correspondence: Tony Antoniou, PhD, 410 Sherbourne St, 4th Floor, Toronto, ON M4X 1K2, Canada (tantoniou@smh.ca).

Abstract

Background.  Statins are widely used lipid-lowering drugs with immunomodulatory properties that may favor reactivation of latent varicella-zoster virus infection. However, whether statins increase the risk of herpes zoster is unknown.

Methods. We conducted a population-based retrospective cohort study of Ontario residents aged ≥66 years between 1 April 1997 and 31 March 2010 to examine the association between statin use and incidence of herpes zoster. We used propensity score matching to ensure similarity between users and nonusers of statins, and Cox proportional hazard models to assess differences in outcomes between study groups. To test the specificity of our findings, we examined the association between statin exposure and knee arthroplasty.

Results. During the 13-year study period, we matched 494 651 individuals treated with a statin to an equal number of untreated individuals. In the main analysis, the rate of herpes zoster was higher among users of statins relative to nonusers of these drugs (13.25 vs 11.71 per 1000 person-years, respectively; hazard ratio [HR], 1.13; 95% confidence interval [CI], 1.10–1.17). The attributable fraction of exposed individuals was 11.6%. In a prespecified analysis, we found a similar risk of herpes zoster among statin users in the subgroup of patients with diabetes (HR, 1.18; 95% CI, 1.09–1.27). As expected, we found no association between statin use and knee arthroplasty (HR, 1.04; 95% CI, .99–1.09).

Conclusions. Among older patients, treatment with statins is associated with a small but significantly increased risk of herpes zoster.