BACKGROUND: Herpes zoster is common and can have serious consequences. Additionally, emerging data suggest an increased risk of acute @entity65 . However, to our knowledge, existing association studies compare outcomes between individuals and are therefore vulnerable to between- @entity1 confounding. In this study, we used a within- @entity1 study design to quantify any short-term increased risk of acute cardiovascular events ( @entity64 and @entity583 [ @entity583 ]) after zoster and to assess whether zoster vaccination modifies this association. METHODS AND FINDINGS: The self-controlled case series method was used to estimate rates of @entity64 and @entity583 in defined periods after herpes zoster compared to other time periods, within individuals. @entity1 were fully eligible Medicare beneficiaries aged >= 65 y with a herpes zoster diagnosis and either an @entity385 (n = 42,954) or @entity583 (n = 24,237) between 1 January 2006 and 31 December 2011. Age-adjusted incidence ratios (IRs) for @entity64 and @entity583 during predefined periods up to 12 mo after zoster relative to unexposed time periods were calculated using conditional Poisson regression. We observed a marked increase in the rate of acute cardiovascular events in the first week after zoster diagnosis: a 2.4-fold increased @entity385 rate (IR 2.37, 95% CI 2.17-2.59) and a 1.7-fold increased @entity583 rate ( @entity24304 .68, 95% CI 1.47-1.92), followed by a gradual resolution over 6 mo. Zoster vaccination did not appear to modify the association with @entity583 (interaction p-value = 0.44). We also found no evidence for a difference in the IR for @entity385 between vaccinated ( @entity24304 .14, 95% CI 0.75-1.74) and unvaccinated ( @entity24304 .78, 95% CI 1.68-1.88) individuals during the first 4 wk after zoster diagnosis (interaction p-value = 0.28). The relatively few vaccinated individuals limited the study's power to assess the role of vaccination. CONCLUSIONS: @entity64 and @entity583 rates are transiently increased after exposure to herpes zoster. We found no evidence for a role of zoster vaccination in these associations. These findings enhance our understanding of the temporality and magnitude of the association between zoster and acute cardiovascular events.

Acute XXXX after Herpes Zoster: A Self-Controlled Case Series Analysis in Vaccinated and Unvaccinated Older Residents of the United States.

@entity1 :: ('9606', 'Species') :: ['Participants', 'person'] @entity64 :: ('MESH:D020521', 'Disease') :: ['stroke', 'Stroke'] @entity24304 :: ('11188', 'Gene') :: ['IR 1'] @entity583 :: ('MESH:D009203', 'Disease') :: ['acute MI', 'myocardial infarction', 'MI'] @entity65 :: ('MESH:D002318', 'Disease') :: ['cardiovascular events following herpes zoster'] @entity385 :: ('MESH:D002544', 'Disease') :: ['ischemic stroke']
@entity65 :: (MESH:D002318,Disease) :: ['Cardiovascular Events']
