1281-OR: Risk of Myocardial Infarction (MI) and Ischemic Stroke (IS) following Herpes Zoster (HZ) in Older Adults with T2DM in the U.S.

Introduction and Objective: HZ has been associated with a higher risk of cardiovascular events, but evidence in T2DM is limited. This analysis assessed associations between HZ and MI/IS in older adults with T2DM. Methods: Using US administrative claims and EHR data (Optum Market Clarity, 2016-2024), adults with T2DM and HZ were identified by ICD-10 diagnosis codes. Four adults with T2DM and no HZ were sampled per HZ case. Index was the first HZ diagnosis or an assigned date for the non-HZ cohort. MI/IS were identified from inpatient ICD-10 diagnosis codes. Crude cumulative MI and IS incidence proportions were described in each cohort among adults aged ≥50 years. Adjusted hazard ratios (HRs) for MI/IS were estimated using Cox proportional hazards models with time-stratified follow-up. Results: Patients with HZ were older and had greater comorbidity burden than those without HZ (Table). Adjusted HRs, accounting for baseline differences between cohorts, indicated a higher risk of MI following HZ in weeks 1-2 (3.38; 95% CI 2.27-5.02) and months 2-3 (1.45; 1.11-1.90) and a higher risk of IS in weeks 1-2 (7.11; 4.43-11.40), weeks 3-4 (2.08; 1.11-3.89), and months 2-3 (1.49; 1.09-2.05) (Table). Conclusion: HZ was associated with a short-term increase in MI and IS risk among older adults with T2DM, highest in the first 2 weeks and generally declining thereafter, highlighting a potential additional burden of HZ. Funding: GSK (study identifier VEO-223763). Disclosure N. Stempniewicz: Employee; Current; GlaxoSmithKline plc. Stock/Shareholder; Current; GlaxoSmithKline plc. A. Steffens: Employee; Current; UnitedHealth Group. Other - Optum (of UnitedHealth Group) received funding from GSK for this project.; Current; GlaxoSmithKline plc. Stock/Shareholder; Current; UnitedHealth Group. S. Hague: None. C. Steiger: Other - I am an employee of Optum who has been paid by GSK to complete the analysis for this manuscript.; Current; GlaxoSmithKline plc. P. Koka: Other - GSK paid Optum to perform research. And I am employee to Optum.; Current; GlaxoSmithKline plc. J. Carrico: Employee; Current; GlaxoSmithKline plc.