Does non-central nervous system tuberculosis increase the risk of ischemic stroke? A population-based propensity score-matched follow-up study

PLoS One. 2014 Jul 21;9(7):e98158. doi: 10.1371/journal.pone.0098158. eCollection 2014.

Abstract

Background: Previous studies on the association between tuberculosis and the risk of developing ischemic stroke have generated inconsistent results. We therefore performed a population-based, propensity score-matched longitudinal follow-up study to investigate whether contracting non-central nervous system (CNS) tuberculosis leads to an increased risk of ischemic stroke.

Methods: We used a logistic regression model that includes age, sex, pre-existing comorbidities and socioeconomic status as covariates to compute the propensity score. A total of 5804 persons with at least three ambulatory visits in 2001 with the principal diagnosis of non-CNS tuberculosis were enrolled in the tuberculosis group. The non-tuberculosis group consisted of 5804, propensity score-matched subjects without tuberculosis. The three-year ischemic stroke-free survival rates for these 2 groups were estimated using the Kaplan-Meier method. The stratified Cox proportional hazards regression was used to estimate the effect of tuberculosis on the occurrence of ischemic stroke.

Results: During three-year follow-up, 176 subjects in the tuberculosis group (3.0%) and 207 in the non-tuberculosis group (3.6%) had ischemic stroke. The hazard ratio for developing ischemic stroke in the tuberculosis group was 0.92 compared to the non-tuberculosis group (95% confidence interval: 0.73-1.14, P = 0.4299).

Conclusions: Non-CNS tuberculosis does not increase the risk of subsequent ischemic stroke.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Brain Ischemia / epidemiology*
  • Brain Ischemia / etiology
  • Databases, Factual
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Propensity Score
  • Risk
  • Stroke / epidemiology*
  • Stroke / etiology
  • Survival Rate
  • Taiwan / epidemiology
  • Tuberculosis / complications*

Grants and funding

This study was supported by grants DOH93-TD-M-113-030, DOH94-TD-M-113-004, and DOH95-TD-M-113-002 from the Department of Health, Executive Yuan, Republic of China. This study used the complete National Health Insurance Research Database provided by the Bureau of National Health Insurance, Department of Health. The interpretation and conclusions contained in this study do not necessarily represent those of the Department of Health, Executive Yuan, Republic of China. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.