Tuberculosis carries increased risk of peripheral arterial disease
Patients with tuberculosis (TB) are at greater risk of developing peripheral arterial disease (PAD) than those who do not have the infection, a population-based cohort study from Taiwan suggests.
Researchers examined the medical records of 14,350 patients with TB and 28,700 matched controls drawn from the Taiwan National Health Insurance Database between 2000 and 2010. Cox proportional hazards regression models were used to estimate the risk of PAD.
Compared with non-TB controls, patients with the infection had a 3.93-fold higher risk of developing PAD. This relationship was independent of age, sex, comorbidities and socioeconomic status. Furthermore, the excess risk of PAD among patients with TB persisted after the first year of follow-up.
PAD affects the noncoronary arteries, especially the arteries supplying the limbs. The disease frequently results from atherosclerosis, but may also be secondary to cardiac or vascular embolism, vasculitis, hypercoagulopathy, vascular dissection and vascular compression syndromes, among others. [Circulation 2012;125:3220–3228]
Previous reports have implicated TB in PAD, and the pathogenic mechanisms typically involved in infection include increased expression of proinflammatory cytokines and immune activation potentially promoting atherogenesis. [Nat Rev Cardiol 2017;14:156–170]
Given the current finding that TB presents an increased risk of PAD, the infection should be considered when evaluating a patient's risk of developing PAD, researchers said.