Major acute cardiovascular events after dengue infection-A population-based observational study

PLoS Negl Trop Dis. 2022 Feb 7;16(2):e0010134. doi: 10.1371/journal.pntd.0010134. eCollection 2022 Feb.

Abstract

Background: Dengue virus (DENV) infection may be associated with increased risks of major adverse cardiovascular effect (MACE), but a large-scale study evaluating the association between DENV infection and MACEs is still lacking.

Methods and findings: All laboratory confirmed dengue cases in Taiwan during 2009 and 2015 were included by CDC notifiable database. The self-controlled case-series design was used to evaluate the association between DENV infection and MACE (including acute myocardial infarction [AMI], heart failure and stroke). The "risk interval" was defined as the first 7 days after the diagnosis of DENV infection and the "control interval" as 1 year before and 1 year after the risk interval. The incidence rate ratio (IRR) and 95% confidence interval (CI) for MACE were estimated by conditional Poisson regression. Finally, the primary outcome of the incidence of MACEs within one year of dengue was observed in 1,247 patients. The IRR of MACEs was 17.9 (95% CI 15.80-20.37) during the first week after the onset of DENV infection observed from 1,244 eligible patients. IRR were significantly higher for hemorrhagic stroke (10.9, 95% CI 6.80-17.49), ischemic stroke (15.56, 95% CI 12.44-19.47), AMI (13.53, 95% CI 10.13-18.06), and heart failure (27.24, 95% CI 22.67-32.73). No increased IRR was observed after day 14.

Conclusions: The risks for MACEs are significantly higher in the immediate time period after dengue infection. Since dengue infection is potentially preventable by early recognition and vaccination, the dengue-associated MACE should be taken into consideration when making public health management policies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Dengue / complications*
  • Dengue / epidemiology
  • Dengue Virus
  • Female
  • Heart Failure / complications*
  • Heart Failure / epidemiology
  • Humans
  • Incidence
  • Infant
  • Male
  • Middle Aged
  • Myocardial Infarction / complications*
  • Myocardial Infarction / epidemiology
  • Risk Factors
  • Stroke / complications*
  • Stroke / epidemiology
  • Taiwan / epidemiology

Grants and funding

The authors thank for the research grand support from the Chang Gung Memorial Hospital, Linkou (CMRPG3J0201) to YTH, and the Ministry of Science and Technology (108-2410-H-182A-002) to YTH. We also acknowledge the support of the Maintenance Project of the Center for Big Data Analytics and Statistics (Grant CLRPG3D0048) at Chang Gung Memorial Hospital to SHC. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.