Elevated rates of CV events, death for adults diagnosed with syphilis
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Key takeaways:
- Ischemic stroke was the most frequent CV event among patients with syphilis.
- Patients with syphilis had increased risk for CV death and all-cause mortality during 5 years of follow-up.
Patients with syphilis experienced higher rates of CV events like stroke, MI and death compared with a matched control group, according to a large-scale, real-world study published in European Heart Journal.
“Early studies have linked syphilis to cardiovascular complications,” Victor Chien-Chia Wu, MD, FACC, FESC, FASE, professor of medicine in the department of cardiology at Chang Gung Memorial Hospital in Taoyuan City, Taiwan, and colleagues wrote. “However, these findings are predominantly based on case reports and case series, lacking large-scale studies.”
Researchers of the real-world, population-based, retrospective cohort study used 2010 to 2015 data from the Taiwan National Health Insurance Research Database to identify 20,601 patients (74% men; mean age, 47.49 years) with syphilis and no history of prior CV events, as well as a pair-matched group by age, sex and comorbidities of 20,601 patients without syphilis (74% men; mean age, 47.85 years).
Researchers evaluated CV events and deaths that occurred in each cohort on or before Dec. 31, 2015.
During the 5-year follow-up, the most frequent CV event among patients with syphilis was ischemic stroke, with an absolute rate (AR) of 4.06 per 1,000 person-years. Compared with patients without syphilis, the relative rate was 68% higher (HR = 1.68; 95% CI, 1.52-1.87).
Patients with syphilis also had higher HRs for the following CV events:
- acute MI (AR = 1.2; HR = 1.38; 95% CI, 1.19-1.6);
- HF (AR = 3.06; HR = 1.88; 95% CI, 1.64-2.14);
- aortic regurgitation (AR = 0.28; HR = 1.81; 95% CI, 1.18-2.75);
- atrial fibrillation (AR = 0.83; HR = 1.45; 95% CI, 1.2-1.76);
- hemorrhagic stroke (AR = 1.55; HR = 2.14; 95% CI, 1.74-2.64); and
- venous thromboembolism (AR = 0.47; HR = 1.67; 95% CI, 1.23-2.26).
Patients with syphilis had higher rates of CV death (AR = 2.38; HR = 2.55; 95% CI, 2.11-3.08) and all-cause death (AR = 18.01; HR = 2.96; 95% CI, 2.74-3.19) compared with those without syphilis.
Researchers noted that patients with syphilis did not have a statistically significant risk for aneurysm and dissection of the aorta compared with the control group.
“Syphilis has diverse effects on the cardiovascular system in patients with chronic syphilis,” researchers wrote. “Recognizing the various cardiovascular presentations associated with syphilis enables early intervention and targeted measures to address complications, leading to improved outcomes for patients with syphilis-related cardiovascular involvement.”
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