Herpes zoster and long-term vascular risk: a retrospective cohort study

Herpes zoster (HZ) represents a serious health problem in the general population due to its abundance and complications. Stroke and acute myocardial infarction are well-documented short-term complications of HZ, primarily due to vasculopathy in the cerebral and coronary arteries. However, no major study to date has specifically demonstrated that HZ is a long-term risk factor for all Major Adverse Cardiac and Cerebrovascular Events (MACCE). A retrospective cohort study was conducted analyzing the association between HZ and MACCE. We compared HZ patients diagnosed between 2001 and 2018 and a matched control group. The model was stratified according to matched pairs and adjusted for age, socioeconomic status, history of dyslipidemia, and prior myocardial infarction (MI). Association between HZ exposure and stroke was assessed through a multivariable Cox regression analysis. The study included 41,930 patients, with 20,965 patients in each group. The risk of MACCE was 19% higher among HZ patients in the first year of follow up (P < 0.001). Antiviral treatment did not positively affect long-term survival among HZ patients (P < 0.001). These results suggest that HZ is a marker of long-term vascular risk. Additional studies will be needed to further evaluate this risk, the impact of HZ vaccination on such risk, and potential mitigation strategies.

Automated summary

Herpes zoster (HZ) is a serious health problem due to its prevalence and complications, including stroke and acute myocardial infarction. A retrospective cohort study was conducted to analyze the association between HZ and Major Adverse Cardiac and Cerebrovascular Events (MACCE). The study found that HZ patients had a 19% higher risk of MACCE in the first year of follow-up and antiviral treatment did not improve long-term survival. Further studies are needed to evaluate the risk of HZ and the impact of HZ vaccination on this risk.