https://scholars.lib.ntu.edu.tw/handle/123456789/586157
標題: | The association of atherosclerotic cardiovascular disease and statin use with inflammation and treatment outcomes in tuberculosis | 作者: | Chidambaram, Vignesh Ruelas Castillo, Jennie Kumar, Amudha Wei, Justin Wang, Siqing Majella, Marie Gilbert Gupte, Akshay JANN-YUAN WANG Karakousis, Petros C |
公開日期: | 2021 | 卷: | 11 | 期: | 1 | 來源出版物: | Scientific reports | 摘要: | Tuberculosis (TB) and atherosclerotic cardiovascular disease (ASCVD) have a close epidemiological and pathogenetic overlap. Thus, it becomes essential to understand the relationship between ASCVD and TB outcomes. From our retrospective cohort on drug-susceptible TB patients at the National Taiwan University Hospital, we assessed the association of pre-existing ASCVD (coronary artery disease (CAD) and atherothrombotic stroke (ATS)) with 9-month all-cause and infection-related mortality and the extent of mediation by systemic inflammatory markers. We determined the effect of pre-existing ASCVD on 2-month sputum microbiological status. Among ASCVD patients, we assessed the association of statin use on mortality. Nine-month all-cause mortality was higher in CAD patients with prior acute myocardial infarction (CAD+AMI+) (adjusted HR 2.01, 95%CI 1.38-3.00) and ATS patients (aHR 2.79, 95%CI 1.92-4.07) and similarly, for infection-related mortality was higher in CAD+AMI+ (aHR 1.95, 95%CI 1.17-3.24) and ATS (aHR 2.04, 95%CI 1.19-3.46) after adjusting for confounding factors. Pre-existing CAD (AMI- or AMI+) or ATS did not change sputum culture conversion or sputum smear AFB positivity at 2 months. The CAD+AMI+ group had significantly higher levels of CRP at TB diagnosis in the multivariable linear regression analysis (Adjusted B(SE) 1.24(0.62)). CRP mediated 66% (P = 0.048) and 25% (P = 0.033) of the association all-cause mortality with CAD+AMI- and CAD+AMI+, respectively. In summary, patients with ASCVD have higher hazards of 9-month all-cause and infection-related mortality, with elevated serum inflammation mediating one to three-quarters of this association when adjusted for confounders. Statin use was associated with lower all-cause mortality among patients with ASCVD. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/586157 | ISSN: | 2045-2322 | DOI: | 10.1038/s41598-021-94590-x | SDG/關鍵字: | hydroxymethylglutaryl coenzyme A reductase inhibitor; aged; atherosclerosis; complication; female; human; inflammation; male; middle aged; retrospective study; treatment outcome; tuberculosis; Aged; Atherosclerosis; Female; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Inflammation; Male; Middle Aged; Retrospective Studies; Treatment Outcome; Tuberculosis |
顯示於: | 醫學系 |
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