Study Links Shingles to Greater Acute Cardiovascular Event Risk

New research finds a connection between herpes zoster—more commonly known as shingles—and higher rates of acute cardiovascular events such as ischemic stroke and heart attack.

In an effort to measure the short-term elevated risk of stroke and myocardial infarction (MI) after zoster—a common virus that can cause shingles—investigators identified 42,954 Medicare beneficiaries, age 65 and over, who had a diagnosis of herpes zoster and an ischemic stroke. The team also studied 24,237 beneficiaries who had a herpes zoster diagnosis and MI over a 5-year span.
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Lead author Caroline Minassian, MSc, PhD, research fellow of epidemiology at the London School of Hygiene and Tropical Medicine, and colleagues calculated participants’ likelihood of experiencing a stroke or myocardial infarction within 12 months of receiving a zoster diagnosis, and compared those figures with times the patient did not have the virus. The authors also adjusted for age.

Minassian and her co-authors found the change of ischemic stroke was 2.4 times greater in those diagnosed with herpes zoster within the past year. The risk of MI in the first week after herpes zoster was 1.7 times higher, compared with the baseline period. The risk decreased steadily over the 6 months following a diagnosis of herpes zoster, according to the researchers, who added that ischemic stroke and MI incidence ratios seemed to be the same regardless of whether participants had been vaccinated against zoster.

The authors note that the study could be limited by not taking major life events and stress into account, and that few participants had been vaccinated, which hampers the ability to detect the effect of the vaccination. But the findings still provide “important information on the timing of increased cardiovascular risk after shingles,” says Minassian, “which could help doctors and healthcare professionals to provide early intervention through closer monitoring of these patients at times of increased risk.

—Mark McGraw

Reference:

Minassian C, Thomas S, et al. Acute cardiovascular events after herpes zoster: a self-controlled case series analysis in vaccinated and unvaccinated older residents of the United States. PLoS Medicine. 2015.