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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
"hypertension"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
aniridia
aromatase deficiency
cadasil
child syndrome
cohen syndrome
congenital adrenal hyperplasia
congenital diaphragmatic hernia
cushing syndrome
cystinuria
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
fabry disease
familial hypocalciuric hypercalcemia
gm1 gangliosidosis
heparin-induced thrombocytopenia
hereditary cerebral hemorrhage with amyloidosis
holt-oram syndrome
homocystinuria without methylmalonic aciduria
hydrocephalus with stenosis of the aqueduct of sylvius
inclusion body myositis
kallmann syndrome
kindler syndrome
lamellar ichthyosis
lymphangioleiomyomatosis
pendred syndrome
primary effusion lymphoma
scrub typhus
severe combined immunodeficiency
sneddon syndrome
typhoid
von hippel-lindau disease
well-differentiated liposarcoma
werner syndrome
x-linked adrenoleukodystrophy
zellweger syndrome
This symptom has already been validated
