The Relationship between Latent Tuberculosis Infection and Acute Myocardial Infarction

Abstract

Background

Tuberculosis has been associated with an increased risk of cardiovascular disease, including acute myocardial infarction (AMI). We investigated whether latent tuberculosis infection (LTBI) associates with AMI.

Methods

We conducted a case-control study in two large national public hospital networks in Lima, Peru between July 2015 and March 2017. Cases were patients with a first time diagnosis of type 1 (spontaneous) AMI. Controls were patients without a history of AMI. We excluded patients with known HIV, TB disease, or prior LTBI treatment. We used the QuantiFERON®-TB Gold In-Tube assay to identify LTBI. We estimated the odds ratio (OR) of LTBI in AMI cases vs. non-AMI controls using logistic regression modeling.

Results

We enrolled 105 AMI cases and 110 non-AMI controls during the study period. Overall, the median age was 62 years (IQR, 56 – 70), 69% were males, 64% had hypertension, 40% dyslipidemia, 39% diabetes mellitus, 30% used tobacco, and 24% were obese. AMI cases were more likely to be males (80% vs. 59%; P<0.01) and tobacco users (41% vs. 20%; P<0.01) compared to non-AMI controls. LTBI was more frequent in AMI cases vs. non-AMI controls (64% vs. 49%; P=0.03; OR, 1.86, 95% CI, 1.08 – 3.22). After adjusting for age, sex, hypertension, dyslipidemia, diabetes mellitus, tobacco use, obesity and family history of coronary artery disease, LTBI remained independently associated with AMI (adjusted OR, 1.90; 95% CI, 1.05 – 3.45).

Conclusions

LTBI was independently associated with AMI. Our results suggest a potentially important role of LTBI in cardiovascular disease.