Table 2. Relative risk data extracted from included studies for systematic literature review of tuberculosis and risk of cardiovascular disease and related mortality.
| First Author | TB Group (definition) | Prevalent CVD Excluded | HIV Population (percent) | CVD Outcome (definition) | Adjustment Variables | Type | Esta | 95% CI | |
|---|---|---|---|---|---|---|---|---|---|
| Bakari | All active TB (history of TB) | No | Yes (only HIV included) | Heart failure (echocardiography) | Age, sex, primary education or less, haemoglobin level, CD4 count | OR | 3.01 | 1.32 | 11.56 |
| Blöndal | Pulmonary-Males (ICD10: A15-A16) | No | Mix (6.1% HIV) | Death from IHD (ICD-10: I20-I25) | Age and sex standardized | SMR | 1.80 | 1.21 | 2.57 |
| Pulmonary-Females (ICD10: A15-A16) | No | Mix (3.4% HIV) | Death from IHD (ICD-10: I20-I25) | Age and sex standardized | SMR | 3.94 | 1.28 | 9.20 | |
| Pulmonary-Males (ICD10: A15-A16) | No | Mix (6.1% HIV) | Death from CBVD (ICD-10: I60-I69) | Age and sex standardized | SMR | 2.08 | 1.04 | 3.71 | |
| Pulmonary-Females (ICD10: A15-A16) | No | Mix (3.4% HIV) | Death from CBVD (ICD-10: I60-I69) | Age and sex standardized | SMR | 3.50 | 0.72 | 10.23 | |
| Christensen | Pulmonary (ICD8: 011–013; ICD10: A15-A17) | No | Mix (1.7% among TB patients) | Death from CVD (ICD-8: 390–458.99; ICD-10: I00–I99) | Age and sex adjusted | MRR | 1.19 | 1.08 | 1.31 |
| Extra-pulmonary (ICD8: 014–019; ICD10: A18-A20) | No | Mix (1.2% among TB patients) | Death from CVD (ICD-8: 390–458.99; ICD-10: I00–I99) | Age and sex adjusted | MRR | 1.09 | 0.92 | 1.28 | |
| Chung | All active TB (ICD9: 011–018) | Yes (excluded anyone with ACS history) | Not stated (presume included) | ACS (ICD9: 410 and 411.1) | Age, sex, hypertension, diabetes, hyperlipidemia, cerebrovascular accident, COPD | HR | 1.40 | 1.14 | 1.72 |
| Hasanain | LTBI (TST>10mm and QuantiFERON-TB Gold positive on both tests) | No (studied first diagnosis of CAS but did not exclude people with other forms of prevalent CVD) | No (people with HIV excluded) | CAS (percutaneous coronary angiography) | Tobacco smoking, obesity, diabetes, dyslipidemia, metabolic syndrome. | OR | 2.50 | 1.20 | 17.30 |
| Huaman (2017) | All active TB (ICD9: 010.0–018.9) | Yes (excluded anyone with AMI claim in prior year or same month of TB claim) | No (people with HIV excluded) | AMI (ICD9: 410.0–410.9) | Age, sex, race, diabetes mellitus, hypertension, hyperlipidemia, obesity, tobacco use, CKD, major autoimmune disease | HR | 1.98 | 1.30 | 3.00 |
| Pulmonary (not stated) | Yes (excluded anyone with AMI claim in prior year or same month of TB claim) | No (people with HIV excluded) | AMI (ICD9: 410.0–410.9) | Age, sex, race, diabetes mellitus, hypertension, hyperlipidemia, obesity, tobacco use, CKD, major autoimmune disease | HR | 2.43 | 1.50 | 4.10 | |
| Huaman (2018) | LTBI (QuantiFERON-TB Gold) | Yes (only first AMI was studied) | No (people with HIV excluded) | AMI (third universal definition of myocardial infarction) | Age, sex, history of hypertension, history of diabetes mellitus, current tobacco use, history of dyslipidemia, family history of CAD, obesity | OR | 1.90 | 1.05 | 3.45 |
| Ke | Pulmonary (ICD9: 011) | No | Mix (1.1% HIV of matched cohort) | Stroke (ICD9: 430–438) | Age, sex, low income, urbanization, types of anesthesia, types of surgery, coexisting diseases (anemia, atrial fibrillation, CHF, COPD, diabetes, HIV, IHD, liver cirrhosis, mental disorder, Parkinson’s, PVD, renal dialysis), organ transplantation, steroid use, emergency operation | OR | 1.02 | 0.85 | 1.21 |
| Pulmonary (ICD9: 011) | No | Mix (1.1% HIV of matched cohort) | AMI (ICD9: 410) | Age, sex, low income, urbanization, types of anesthesia, types of surgery, coexisting diseases (anemia, atrial fibrillation, CHF, COPD, diabetes, HIV, IHD, liver cirrhosis, mental disorder, Parkinson’s, PVD, renal dialysis), organ transplantation, steroid use, emergency operation | OR | 0.89 | 0.57 | 1.38 | |
| Mathew | All active TB (Tomsk Oblast TB Services) | No | Mix (0.4% HIV) | Vascular disease death (death certificate primary cause of death) | Age and sex standardized | SMR | 1.75 | 1.45 | 2.09 |
| Oh | All active TB (treated with standard regimen) | Not stated | Not stated | CBVE or AMI (not stated) | Age and sex standardized | SIR | 2.89 | 2.58 | 3.23 |
| Pettit | All active TB (US-CDC definition of confirmed case) | No | Yes (only HIV included) | Death from CVD (CoDe: 08, 09, 12, 24) | CD4+ count, baseline HIV-1 RNA, sex, HIV transmission risk group, age, year of ART initiation, baseline ART regimen, ADE at or prior to the time of enrollment and ART-CC cohort | HR | 2.90 | 1.57 | 5.36 |
| Sheu | Non-CNS and non-meningitis TB (ICD9: 010–012, 014–018) | Yes (excluded anyone with stroke prior to index) | Mix (<0.1% HIV) | Ischemic stroke (ICD9: 433–438) | Age, sex, hypertension, diabetes, malignancy, coronary heart disease, hyperlipidemia, monthly income, geographical region, urbanization level, number of CT/MRI scans during follow-up period | HR | 1.52 | 1.21 | 1.91 |
| Non-CNS and non-meningitis TB (ICD9: 010–012, 014–018) | Yes (excluded anyone with stroke prior to index) | Mix (<0.1% HIV) | Hemorrhagic stroke (not stated) | Age, sex, hypertension, diabetes, malignancy, coronary heart disease, hyperlipidemia, monthly income, geographical region, urbanization level, number of CT/MRI scans during follow-up period | HR | 0.94 | 0.50 | 1.79 | |
| Non-CNS and non-meningitis TB (ICD9: 010–012, 014–018) | Yes (excluded anyone with stroke prior to index) | Mix (<0.1% HIV) | Coronary Heart Disease (not stated) | Age, sex, hypertension, diabetes, malignancy, coronary heart disease, hyperlipidemia, monthly income, geographical region, urbanization level, number of CT/MRI scans during follow-up period | HR | 1.21 | 1.08 | 1.36 | |
| Wang | All active TB (ICD9: 010–018) | Yes (excluded anyone with PAD prior to index) | Mix (<1% HIV) | PAD (ICD9: 440.0, 440.2–440.3, 440.8–440.9, 443, 444.0, 444.22, 444.8 and 447.8–447.9) | Age, sex, diabetes mellitus, hypertension, hyperlipidemia, CVD, stroke, COPD, asthma, CKD, HIV, HCV, urbanization level, insured premium | HR | 3.93 | 3.03 | 4.95 |
| Pulmonary (ICD9: 011) | Yes (excluded anyone with PAD prior to index) | Mix (<1% HIV) | PAD (ICD9: 440.0, 440.2–440.3, 440.8–440.9, 443, 444.0, 444.22, 444.8 and 447.8–447.9) | Age, sex, diabetes mellitus, hypertension, hyperlipidemia, CVD, stroke, COPD, asthma, CKD, HIV, HCV, urbanization level, insured premium | HR | 3.90 | 2.94 | 4.86 | |
| Extra-Pulmonary (ICD9: 010, 012–017) | Yes (excluded anyone with PAD prior to index) | Mix (<1% HIV) | PAD (ICD9: 440.0, 440.2–440.3, 440.8–440.9, 443, 444.0, 444.22, 444.8 and 447.8–447.9) | Age, sex, diabetes mellitus, hypertension, hyperlipidemia, CVD, stroke, COPD, asthma, CKD, HIV, HCV, urbanization level, insured premium | HR | 2.11 | 1.31 | 3.56 | |
| Miliary (ICD9: 018) | Yes (excluded anyone with PAD prior to index) | Mix (<1% HIV) | PAD (ICD9: 440.0, 440.2–440.3, 440.8–440.9, 443, 444.0, 444.22, 444.8 and 447.8–447.9) | Age, sex, diabetes mellitus, hypertension, hyperlipidemia, CVD, stroke, COPD, asthma, CKD, HIV, HCV, urbanization level, insured premium | HR | 2.56 | 0.68 | 10.49 | |
| Wu | Non-CNS and non-meningitis TB (ICD9: 010–012, 014–018) | Yes (excluded anyone with stroke prior to index) | Not stated | Ischemic stroke (ICD9: 433–437) | Age, sex, hypertension, diabetes, atrial fibrillation, chronic rheumatic heart disease, coronary heart disease, other heart disease, hyperlipidemia, monthly income, urbanization level, and geographic region | HR | 0.92 | 0.73 | 1.14 |
ACS = acute coronary syndrome, ADE = AIDS defining event, AMI = acute myocardial infarction, ART = anti-retroviral treatment, ART-CC = Antiretroviral Therapy Cohort Collaboration, CAD = coronary artery disease, CAS = coronary artery stenosis, CBVD = cerebrovascular disease, CBVE = cerebrovascular event, CHF = congestive heart failure, CI = confidence interval, CKD = chronic kidney disease, CNS = central nervous system, CoDe = Coding of Death in HIV Project, COPD = chronic obstructive pulmonary disorder, CVD = cardiovascular disease, CT = computed tomography, Est. = estimate, HCV = hepatitis C virus, HIV = human immunodeficiency virus, HR = hazard ratio, IHD = ischemic heart disease, LTBI = latent tuberculosis infection, MRI = magnetic resonance imaging, MRR = mortality rate ratio, NI = no information, OR = odds ratio, PAD = peripheral arterial disease, PVD = peripheral vascular disease, TB = tuberculosis, SIR = standardized incidence ratio, SMR = standardized mortality ratio.
aAll estimates (Est.) are adjusted for (or standardized by) variables listed in “Adjustment Variables” column.