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Scrub typhus increases the risk of developing acute coronary syndrome: a nationwide cohort study.
[scrub typhus]
Studies
investigating
the
epidemiological
relationship
between
scrub
typhus
and
the
subsequent
development
of
acute
coronary
syndrome
(
ACS
)
are
lacking
.
Therefore
,
we
conducted
a
nationwide
longitudinal
cohort
study
in
Taiwan
to
explore
whether
patients
with
scrub
typhus
are
at
an
increased
risk
of
developing
ACS
.
This
study
investigated
the
incidence
and
risk
factors
for
ACS
in
5215
patients
newly
diagnosed
with
scrub
typhus
from
the
Taiwan
National
Health
Insurance
Research
Database
between
2000
and
2011
.
The
comparison
cohort
contained
20
 
860
persons
from
the
general
population
without
scrub
typhus
.
The
follow-up
period
ran
from
the
time
of
the
initial
diagnosis
for
scrub
typhus
to
the
date
of
an
ACS
event
,
censoring
,
or
31
December
2011
.
We
used
Cox
proportional
hazard
regression
models
to
analyse
the
risk
of
ACS
by
including
the
variables
of
sex
,
age
and
comorbidities
.
The
incidence
of
ACS
was
higher
in
patients
with
scrub
typhus
than
in
the
comparison
cohort
(
3
.
10
vs
1
.
92
per
1000
person-
years
)
.
The
HR
of
developing
ACS
increased
by
37
%
in
patients
with
scrub
typhus
after
adjusting
for
age
,
sex
and
comorbidities
.
Men
,
increased
age
,
hypertension
,
diabetes
,
hyperlipidaemia
,
chronic
obstructive
pulmonary
disease
and
coronary
artery
disease
were
identified
as
independent
risk
factors
of
developing
ACS
after
controlling
for
covariates
.
The
prominent
effect
of
scrub
typhus
on
subsequent
ACS
development
appeared
within
1
 
year
after
infection
.
This
nationwide
study
determined
that
patients
with
scrub
typhus
exhibited
a
37
%
increase
in
the
risk
of
subsequently
developing
ACS
compared
with
that
of
the
general
population
.
Diseases
Validation
Diseases presenting
"increased risk of developing acs.this study"
symptom
scrub typhus
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