Tuberculosis and the Risk of Ischemic Stroke

Abstract

The aim of this study is to estimate the risk of ischemic stroke during a 3-year follow-up period after a tuberculosis diagnosis using a nationwide, population-based study and a retrospective cohort design. The study cohort comprised 2283 patients who had received treatment for tuberculosis, except tuberculosis of the meninges and central nervous system, between 2000 and 2003; 6849 randomly selected subjects comprised the comparison cohort. Cox proportional hazard regressions were performed as a means of comparing the 3-year ischemic stroke-free survival rate between these 2 cohorts. Of the 9132 sampled patients, 392 (4.3%) experienced ischemic stroke during the 3-year follow-up period, including 136 (6.0% of the tuberculosis patients) from the study cohort and 256 (3.7%) from the comparison cohort. After adjusting for patient age, gender, hypertension, diabetes, coronary heart disease, hyperlipidemia, malignancy, monthly income, and the geographical region and urbanization level of the community in which the patient resided, the hazard ratio of ischemic stroke for tuberculosis patients was 1.52-times (95% CI, 1.21-1.91; P<0.001) higher than for comparison patients. We conclude that patients with a tuberculosis diagnosis are at an increased risk for ischemic stroke but not hemorrhagic stroke in the next 3 years. Further research is necessary to investigate these findings in tuberculosis-endemic areas.