Syphilis and cardiovascular risk: a Taiwanese registry

Victor Chien Chia Wu; Jih Kai Yeh; Shao Wei Chen; Chia Ling Wu; Yu Sheng Lin; Michael Wu; Kai Che Wei; Pao Hsien Chu; Shang Hung Chang; Yu Tung Huang

doi:10.1093/eurheartj/ehae183

Syphilis and cardiovascular risk: a Taiwanese registry

Victor Chien Chia Wu
, Jih Kai Yeh
, Shao Wei Chen
, Chia Ling Wu
, Yu Sheng Lin
, Michael Wu
, Kai Che Wei
, Pao Hsien Chu
, Shang Hung Chang^*
, Yu Tung Huang^*

^*Corresponding author for this work

Chang Gung Memorial Hospital
Chang Gung University
Brown University
Veterans General Hospital-Kaohsiung Taiwan
National Yang Ming Chiao Tung University
Chang Gung University of Science and Technology

Research output: Contribution to journal › Journal Article › peer-review

16 Scopus citations

Abstract

BACKGROUND AND AIMS: Studies on the impact of syphilis on the cardiovascular system in large populations are limited. This study investigated the effects of syphilis on cardiovascular outcomes.

METHODS: Medical records from 2010 to 2015 were retrieved from the Taiwan National Health Insurance Research Database, linked to the Notifiable Infectious Diseases database from the Taiwan Centers for Disease Control. Patients with syphilis were identified, excluding those with missing information, under 20 years of age, or with a history of human immunodeficiency virus infection, acute myocardial infarction, heart failure, aortic regurgitation, replacement of the aortic valve, aneurysm and/or dissection of the aorta, atrial fibrillation, ischaemic stroke, haemorrhagic stroke, and venous thromboembolism. Primary outcomes included new-onset acute myocardial infarction, heart failure, aortic regurgitation, aneurysm and dissection of the aorta, atrial fibrillation, ischaemic stroke, haemorrhagic stroke, venous thromboembolism, cardiovascular death, and all-cause mortality.

RESULTS: A total of 28 796 patients with syphilis were identified from 2010 to 2015. After exclusions and frequency matching, 20 601 syphilis patients and 20 601 non-syphilis patients were analysed. The relative rate (RR) was utilized in the analysis, as the competing risk of death was not considered. Compared with patients without syphilis, patients with syphilis had increased risks of acute myocardial infarction (RR 38%, 95% confidence interval [CI] 1.19-1.60, P < .001), heart failure (RR 88%, 95% CI 1.64-2.14, P < .001), aortic regurgitation (RR 81%, 95% CI 1.18-2.75, P = .006), atrial fibrillation (RR 45%, 95% CI 1.20-1.76, P < .001), ischaemic stroke (RR 68%, 95% CI 1.52-1.87, P < .001), haemorrhagic stroke (RR 114%, 95% CI 1.74-2.64, P < .001), venous thromboembolism (RR 67%, 95% CI 1.23-2.26, P = .001), cardiovascular death (RR 155%, 95% CI 2.11-3.08, P < .001), and all-cause death (RR 196%, 95% CI 2.74-3.19, P < .001) but not for aneurysm and dissection of the aorta.

CONCLUSIONS: This study demonstrates that patients with syphilis have a higher risk of cardiovascular events and all-cause mortality compared with those without syphilis.

Original language	English
Pages (from-to)	1512-1520
Number of pages	9
Journal	European Heart Journal
Volume	45
Issue number	17
DOIs	https://doi.org/10.1093/eurheartj/ehae183
State	Published - 07 05 2024
Externally published	Yes

Bibliographical note

© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected].

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

All-cause death
Cardiovascular death
Cardiovascular events
Outcome
Syphilis
Heart Failure/epidemiology
Myocardial Infarction/epidemiology
Cardiovascular Diseases/mortality
Humans
Middle Aged
Male
Syphilis/epidemiology
Taiwan/epidemiology
Female
Registries
Adult
Aged
Heart Disease Risk Factors
Retrospective Studies

Access to Document

10.1093/eurheartj/ehae183

Cite this

@article{7fad28f8cb144cedac8983606195dd9b,

title = "Syphilis and cardiovascular risk: a Taiwanese registry",

abstract = "BACKGROUND AND AIMS: Studies on the impact of syphilis on the cardiovascular system in large populations are limited. This study investigated the effects of syphilis on cardiovascular outcomes.METHODS: Medical records from 2010 to 2015 were retrieved from the Taiwan National Health Insurance Research Database, linked to the Notifiable Infectious Diseases database from the Taiwan Centers for Disease Control. Patients with syphilis were identified, excluding those with missing information, under 20 years of age, or with a history of human immunodeficiency virus infection, acute myocardial infarction, heart failure, aortic regurgitation, replacement of the aortic valve, aneurysm and/or dissection of the aorta, atrial fibrillation, ischaemic stroke, haemorrhagic stroke, and venous thromboembolism. Primary outcomes included new-onset acute myocardial infarction, heart failure, aortic regurgitation, aneurysm and dissection of the aorta, atrial fibrillation, ischaemic stroke, haemorrhagic stroke, venous thromboembolism, cardiovascular death, and all-cause mortality.RESULTS: A total of 28 796 patients with syphilis were identified from 2010 to 2015. After exclusions and frequency matching, 20 601 syphilis patients and 20 601 non-syphilis patients were analysed. The relative rate (RR) was utilized in the analysis, as the competing risk of death was not considered. Compared with patients without syphilis, patients with syphilis had increased risks of acute myocardial infarction (RR 38\%, 95\% confidence interval [CI] 1.19-1.60, P < .001), heart failure (RR 88\%, 95\% CI 1.64-2.14, P < .001), aortic regurgitation (RR 81\%, 95\% CI 1.18-2.75, P = .006), atrial fibrillation (RR 45\%, 95\% CI 1.20-1.76, P < .001), ischaemic stroke (RR 68\%, 95\% CI 1.52-1.87, P < .001), haemorrhagic stroke (RR 114\%, 95\% CI 1.74-2.64, P < .001), venous thromboembolism (RR 67\%, 95\% CI 1.23-2.26, P = .001), cardiovascular death (RR 155\%, 95\% CI 2.11-3.08, P < .001), and all-cause death (RR 196\%, 95\% CI 2.74-3.19, P < .001) but not for aneurysm and dissection of the aorta.CONCLUSIONS: This study demonstrates that patients with syphilis have a higher risk of cardiovascular events and all-cause mortality compared with those without syphilis.",

keywords = "All-cause death, Cardiovascular death, Cardiovascular events, Outcome, Syphilis, Heart Failure/epidemiology, Myocardial Infarction/epidemiology, Cardiovascular Diseases/mortality, Humans, Middle Aged, Male, Syphilis/epidemiology, Taiwan/epidemiology, Female, Registries, Adult, Aged, Heart Disease Risk Factors, Retrospective Studies",

author = "Wu, \{Victor Chien Chia\} and Yeh, \{Jih Kai\} and Chen, \{Shao Wei\} and Wu, \{Chia Ling\} and Lin, \{Yu Sheng\} and Michael Wu and Wei, \{Kai Che\} and Chu, \{Pao Hsien\} and Chang, \{Shang Hung\} and Huang, \{Yu Tung\}",

note = "{\textcopyright} The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site{\textemdash}for further information please contact [email protected].",

year = "2024",

month = may,

day = "7",

doi = "10.1093/eurheartj/ehae183",

language = "英语",

volume = "45",

pages = "1512--1520",

journal = "European Heart Journal",

issn = "0195-668X",

publisher = "Oxford University Press",

number = "17",

}

TY - JOUR

T1 - Syphilis and cardiovascular risk

T2 - a Taiwanese registry

AU - Wu, Victor Chien Chia

AU - Yeh, Jih Kai

AU - Chen, Shao Wei

AU - Wu, Chia Ling

AU - Lin, Yu Sheng

AU - Wu, Michael

AU - Wei, Kai Che

AU - Chu, Pao Hsien

AU - Chang, Shang Hung

AU - Huang, Yu Tung

N1 - © The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected].

PY - 2024/5/7

Y1 - 2024/5/7

N2 - BACKGROUND AND AIMS: Studies on the impact of syphilis on the cardiovascular system in large populations are limited. This study investigated the effects of syphilis on cardiovascular outcomes.METHODS: Medical records from 2010 to 2015 were retrieved from the Taiwan National Health Insurance Research Database, linked to the Notifiable Infectious Diseases database from the Taiwan Centers for Disease Control. Patients with syphilis were identified, excluding those with missing information, under 20 years of age, or with a history of human immunodeficiency virus infection, acute myocardial infarction, heart failure, aortic regurgitation, replacement of the aortic valve, aneurysm and/or dissection of the aorta, atrial fibrillation, ischaemic stroke, haemorrhagic stroke, and venous thromboembolism. Primary outcomes included new-onset acute myocardial infarction, heart failure, aortic regurgitation, aneurysm and dissection of the aorta, atrial fibrillation, ischaemic stroke, haemorrhagic stroke, venous thromboembolism, cardiovascular death, and all-cause mortality.RESULTS: A total of 28 796 patients with syphilis were identified from 2010 to 2015. After exclusions and frequency matching, 20 601 syphilis patients and 20 601 non-syphilis patients were analysed. The relative rate (RR) was utilized in the analysis, as the competing risk of death was not considered. Compared with patients without syphilis, patients with syphilis had increased risks of acute myocardial infarction (RR 38%, 95% confidence interval [CI] 1.19-1.60, P < .001), heart failure (RR 88%, 95% CI 1.64-2.14, P < .001), aortic regurgitation (RR 81%, 95% CI 1.18-2.75, P = .006), atrial fibrillation (RR 45%, 95% CI 1.20-1.76, P < .001), ischaemic stroke (RR 68%, 95% CI 1.52-1.87, P < .001), haemorrhagic stroke (RR 114%, 95% CI 1.74-2.64, P < .001), venous thromboembolism (RR 67%, 95% CI 1.23-2.26, P = .001), cardiovascular death (RR 155%, 95% CI 2.11-3.08, P < .001), and all-cause death (RR 196%, 95% CI 2.74-3.19, P < .001) but not for aneurysm and dissection of the aorta.CONCLUSIONS: This study demonstrates that patients with syphilis have a higher risk of cardiovascular events and all-cause mortality compared with those without syphilis.

AB - BACKGROUND AND AIMS: Studies on the impact of syphilis on the cardiovascular system in large populations are limited. This study investigated the effects of syphilis on cardiovascular outcomes.METHODS: Medical records from 2010 to 2015 were retrieved from the Taiwan National Health Insurance Research Database, linked to the Notifiable Infectious Diseases database from the Taiwan Centers for Disease Control. Patients with syphilis were identified, excluding those with missing information, under 20 years of age, or with a history of human immunodeficiency virus infection, acute myocardial infarction, heart failure, aortic regurgitation, replacement of the aortic valve, aneurysm and/or dissection of the aorta, atrial fibrillation, ischaemic stroke, haemorrhagic stroke, and venous thromboembolism. Primary outcomes included new-onset acute myocardial infarction, heart failure, aortic regurgitation, aneurysm and dissection of the aorta, atrial fibrillation, ischaemic stroke, haemorrhagic stroke, venous thromboembolism, cardiovascular death, and all-cause mortality.RESULTS: A total of 28 796 patients with syphilis were identified from 2010 to 2015. After exclusions and frequency matching, 20 601 syphilis patients and 20 601 non-syphilis patients were analysed. The relative rate (RR) was utilized in the analysis, as the competing risk of death was not considered. Compared with patients without syphilis, patients with syphilis had increased risks of acute myocardial infarction (RR 38%, 95% confidence interval [CI] 1.19-1.60, P < .001), heart failure (RR 88%, 95% CI 1.64-2.14, P < .001), aortic regurgitation (RR 81%, 95% CI 1.18-2.75, P = .006), atrial fibrillation (RR 45%, 95% CI 1.20-1.76, P < .001), ischaemic stroke (RR 68%, 95% CI 1.52-1.87, P < .001), haemorrhagic stroke (RR 114%, 95% CI 1.74-2.64, P < .001), venous thromboembolism (RR 67%, 95% CI 1.23-2.26, P = .001), cardiovascular death (RR 155%, 95% CI 2.11-3.08, P < .001), and all-cause death (RR 196%, 95% CI 2.74-3.19, P < .001) but not for aneurysm and dissection of the aorta.CONCLUSIONS: This study demonstrates that patients with syphilis have a higher risk of cardiovascular events and all-cause mortality compared with those without syphilis.

KW - All-cause death

KW - Cardiovascular death

KW - Cardiovascular events

KW - Outcome

KW - Syphilis

KW - Heart Failure/epidemiology

KW - Myocardial Infarction/epidemiology

KW - Cardiovascular Diseases/mortality

KW - Humans

KW - Middle Aged

KW - Male

KW - Syphilis/epidemiology

KW - Taiwan/epidemiology

KW - Female

KW - Registries

KW - Adult

KW - Aged

KW - Heart Disease Risk Factors

KW - Retrospective Studies

UR - https://www.scopus.com/pages/publications/85192632015

U2 - 10.1093/eurheartj/ehae183

DO - 10.1093/eurheartj/ehae183

M3 - 文章

C2 - 38568209

AN - SCOPUS:85192632015

SN - 0195-668X

VL - 45

SP - 1512

EP - 1520

JO - European Heart Journal

JF - European Heart Journal

IS - 17

ER -

Syphilis and cardiovascular risk: a Taiwanese registry

Abstract

Bibliographical note

UN SDGs

Keywords

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