Angiotensin-Converting Enzyme Inhibitors and Active Tuberculosis: A Population-Based Study
| Autor: | Meng-Tse Gabriel Lee, Shy-Shin Chang, Shou-Chien Hsu, Chien-Chang Lee, S.-H. Lee, Shih Hao Lee, Yi-Wen Tsai, Jiunn-Yih Wu |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Tuberculosis Time Factors Databases Factual Taiwan Observational Study Angiotensin-Converting Enzyme Inhibitors 030204 cardiovascular system & hematology Risk Assessment 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Diabetes mellitus Epidemiology medicine Humans cardiovascular diseases 030212 general & internal medicine Longitudinal Studies Tuberculosis Pulmonary business.industry Case-control study General Medicine medicine.disease Surgery Pneumonia Logistic Models Heart failure Case-Control Studies Cohort ComputingMethodologies_DOCUMENTANDTEXTPROCESSING Female business Risk assessment Post-Exposure Prophylaxis Research Article |
| Zdroj: | Medicine |
| ISSN: | 1536-5964 |
| Popis: | Supplemental Digital Content is available in the text Numerous epidemiological data suggest that the use of angiotensin-converting enzyme inhibitors (ACEis) can improve the clinical outcomes of pneumonia. Tuberculosis (TB) is an airborne bacteria like pneumonia, and we aimed to find out whether the use of ACEis can decrease the risk of active TB. We conducted a nested case–control analysis by using a 1 million longitudinally followed cohort, from Taiwan national health insurance research database. The rate ratios (RRs) for TB were estimated by conditional logistic regression, and adjusted using a TB-specific disease risk score (DRS) with 71 TB-related covariates. From January, 1997 to December, 2011, a total of 75,536 users of ACEis, and 7720 cases of new active TB were identified. Current use (DRS adjusted RR, 0.87 [95% CI, 0.78–0.97]), but not recent and past use of ACEis, was associated with a decrease in risk of active TB. Interestingly, it was found that chronic use (>90 days) of ACEis was associated with a further decrease in the risk of TB (aRR, 0.74, [95% CI, 0.66–0.83]). There was also a duration response effect, correlating decrease in TB risk with longer duration of ACEis use. The decrease in TB risk was also consistent across all patient subgroups (age, sex, heart failure, cerebrovascular diseases, myocardial infraction, renal diseases, and diabetes) and patients receiving other cardiovascular medicine. In this large population-based study, we found that subjects with recent and chronic use of ACEis were associated with decrease in TB risk. |
| Databáze: | OpenAIRE |
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