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

• Published in: PLoS neglected tropical diseases Vol. 16; no. 2; p. e0010134
• Main Authors: Wei, Kai-Che, Sy, Cheng-Len, Wang, Wen-Hwa, Wu, Chia-Ling, Chang, Shang-Hung, Huang, Yu-Tung
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 01-02-2022; Public Library of Science (PLoS)
• Subjects: Adolescent; Adult; Biology and life sciences; Cardiovascular diseases; Cerebral infarction; Child; Child, Preschool; Complications and side effects; Confidence intervals; Congestive heart failure; COVID-19; Dengue; Dengue - complications; Dengue - epidemiology; Dengue fever; Dengue Virus; Diagnosis; Female; Health risks; Heart; Heart diseases; Heart Failure - complications; Heart Failure - epidemiology; Hemorrhage; Human diseases; Humans; Incidence; Infant; Infections; Ischemia; Male; Medicine and Health Sciences; Middle Aged; Myocardial infarction; Myocardial Infarction - complications; Myocardial Infarction - epidemiology; Observational studies; Population studies; Population-based studies; Public health; Risk Factors; Statistical analysis; Stroke; Stroke - complications; Stroke - epidemiology; Taiwan - epidemiology; Tropical diseases; Vaccination; Vector-borne diseases; Viral infections; Viruses; Taiwan
• ISSN: 1935-2735; 1935-2727; 1935-2735
• DOI: 10.1371/journal.pntd.0010134

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.
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.
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.