Association between latent tuberculosis and ischemic heart disease: a hospital-based cross-sectional study from Saudi Arabia.
Association between latent tuberculosis and ischemic heart disease: a hospital-based cross-sectional study from Saudi Arabia.
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DOI：
10.11604/pamj.2021.38.362.28110
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Khoufi EAA
中科院分区：
文献类型：
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作者：
Khoufi EAA
动脉粥样硬化可能是长期激活细胞介导的免疫的后遗症，如潜伏性结核感染的情况。动脉粥样硬化是缺血性心脏病的主要病理事件。本研究旨在评估缺血性心脏病（IHD）患者中潜伏性结核感染（LTBI）的患病率，并检测两种疾病之间的相关性。该横断面研究包括98名既往诊断为缺血性心脏病的患者，他们进行了多探测器计算机断层扫描冠状动脉血管造影（MDCTCA）。对QuantiFERON-TB Gold试验（QFT）阳性的患者进行详细的临床检查和胸部X线、痰液检查，以排除活动性肺结核（TB）。具有阳性QFT结果但没有活动性TB证据的参与者被认为是LTBI阳性。IHD患者中LTBI的患病率为19.3%，因为使用QuantiFERON血清试验，98名患者中只有19名被诊断为潜伏性结核感染。84%（84.2%）的LTBI患者有冠状动脉粥样硬化（CAA），而无LTBI的患者只有55.6%，差异有统计学意义。在多变量分析中，糖尿病（DM）（AOR 0.179，95% C.I.：0.03-0.967）和LTBI（AOR 1.024，95% C.I.：1.002-1.736）与冠状动脉粥样硬化显著相关（分别为p=0.0001和p= 0.003）。在患有缺血性心脏病的患者中，潜伏性结核病感染的流行率很高。在各种已知的诱发缺血性心脏病的因素中，潜伏性结核病应被考虑在内。
atherosclerosis could be a sequela of long-term activation of cell-mediated immunity as the case of latent tuberculosis infection. Atherosclerosis is the main pathological event in ischemic heart disease. The present study aimed to assess the prevalence of Latent tuberculosis infection (LTBI) among patients with ischemic heart disease (IHD) and to detect the association between both diseases. this cross-sectional study included 98 patients with a history of previously diagnosed ischemic heart disease who did a multi-detector computed tomography coronary angiogram (MDCTCA). Detailed clinical examination and investigations as chest X-ray and sputum examination were done for those with positive QuantiFERON-TB Gold test (QFT) to exclude active tuberculosis (TB). Participants having positive QFT results but with no evidence of active TB were considered as LTBI positive. the prevalence of LTBI in patients with IHD was 19.3% as only nineteen of the ninety-eight patients were diagnosed with latent tuberculosis infection using the QuantiFERON serum test. Eighty-four percent (84.2%) of patients with LTBI had coronary artery atherosclerosis (CAA) compared to only 55.6% in patients without LTBI with a statistically significant difference. In multivariable analysis, Diabetes Mellitus (DM) (AOR 0.179, 95% C.I.: 0.03-0.967), and LTBI (AOR 1.024, 95% C.I.: 1.002-1.736) were significantly associated with coronary artery atherosclerosis (p=0.0001, and p= 0.003 respectively). the prevalence of latent tuberculosis infection among patients with ischemic heart diseases is high. Among different factors that are already well known to precipitate ischemic heart disease, latent tuberculosis should be considered.