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Observational Study
. 2022 Feb 7;16(2):e0010134.
doi: 10.1371/journal.pntd.0010134. eCollection 2022 Feb.

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

Kai-Che Wei  1   2 , Cheng-Len Sy  3 , Wen-Hwa Wang  4   5   6 , Chia-Ling Wu  7 , Shang-Hung Chang  7   8   9 , Yu-Tung Huang  7
Affiliations
Observational Study

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

Kai-Che Wei et al. PLoS Negl Trop Dis. .

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.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Schematic of study design.
MACE (A) represents a person who is infected with DENV and is hospitalized for MACE (major adverse cardiovascular events) at any time during the 7-day risk interval (light-shaded areas) after exposure. Another MACE (B) represents a person infected with DENV who has an acute MACE during the control interval (dark-shaded areas). The study assessed the relative incidence of MACE during the risk interval as compared with the control interval. Note that the figure is not drawn to scale.
Fig 2
Fig 2. Dengue virus infection cases included in the study.
See this image and copyright information in PMC

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