Latent tuberculosis infection and incident cardiovascular and non-cardiovascular death

Active tuberculosis may heighten the risk of incident cardiovascular morbidity and premature mortality, whereas whether latent TB infection (LTBI) recapitulates these adverse outcomes is unclear. We evaluated the effect of LTBI on all-cause and cardiovascular-specific death among US adults who underwent tuberculin skin testing in 1999-2000 and were followed up to December 31st, 2019. We also examined the impact of co-occurring traditional risk factors on these outcomes. Adjustments were made for socio-economic and demographic factors. LTBI was defined as tuberculin skin induration ≥10mm, and cause of death as cardiovascular if from heart or cerebrovascular diseases, and non-cardiovascular if otherwise. LTBI was associated with increased of overall and non-cardiovascular specific death but not cardiovascular-specific death. Risk of death was highest when LTBI was comorbid LTBI with diabetes. LTBI may increase risk of death by mechanisms other than progression to active TB disease. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement RJW is funded by the Francis Crick Institute which is supported by the Medical Research Council (CC2112), Cancer research UK (CC2112) and Wellcome (CC2112). He also receives support from Wellcome (203135). NABN gratefully acknowledges funding from the National Research Foundation, South African Medical Research Council, US National Institutes of Health, Medical Research Council (UK), and the Lily and Ernst Hausmann Trust. For the purposes of open access, the authors have applied a CC-BY public copyright license to any author-accepted manuscript arising from this submission. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: All data used in this study are publicly accessible in a de-identified format at: https://www.cdc.gov/nchs/nhanes/about_nhanes.htm I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced are available online at: https://www.cdc.gov/nchs/nhanes/about_nhanes.htm