Citation

Yang TY, Chen HJ, Sung FC, Kao CH. Spine 2014; 40(3): 147-152.

Affiliation

aMolecular and Genomic Epidemiology Center, China Medical University Hospital, Taichung, Taiwan. bDivision of Nephrology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan. cManagement Office for Health Data, China Medical University Hospital, Taichung, Taiwan dGraduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan. eDepartment of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.

Copyright

(Copyright © 2014, Lippincott Williams and Wilkins)

DOI

10.1097/BRS.0000000000000704

PMID

25394315

Abstract

STRUCTURED ABSTRACT:: Study Design. A spinal cord injury (SCI) retrospective cohort study was derived from National Health Insurance Research Database (NHIRD) of Taiwan.

OBJECTIVE. We evaluated risks of developing acute myocardial infarction (AMI) in patients newly diagnosed with SCI.Summary of Background Data. According to information of World Health Organization, cardiovascular diseases (CVDs) are the most frequent causes of death in SCI patients which compared to general population.

METHODS. We obtained claim data from the NHIRD for this cohort study. The SCI group comprised 22 197 patients diagnosed with SCI. Case and control patients which based on risk-set sampling in a 1:4 ratio, and excluded patients with a prior diagnosis of AMI. Comorbidities were categorized as proportion of prior illnesses in SCI and non-SCI groups respectively. We used Cox proportion model to explore adjusted hazard ratio (aHR) for AMI between case and control patients.

RESULTS. The SCI patients were significantly more likely to exhibit preexisting illnesses associated with AMI than non-SCI patients were. Patients diagnosed with SCI exhibited significantly higher aHRs of developing AMI, than non-SCI patients (aHR = 1.17, p<0.05). Patients with SCI, compared to non-SCI, was associated with subsequent AMI risk (aHR = 1.17, p<0.05). Several comorbidities were associated with increased risk, like CVD (aHR = 1,29, p<0.05), chronic obstructive pulmonary disease (COPD) (aHR = 1,51, p<0.05), hypertension (aHR = 1,34, p<0.01), and renal disease (aHR = 1,76, p<0.05). Furthermore T-spine SCI were significantly associated with AMI risk (aHR = 1,38, p<0.05).

CONCLUSION. Patients diagnosed with SCI exhibited an increased risk for AMI than patients without SCI. These findings have broad implications for surveillance for SCI patients and future studies should evaluate whether risk factor modification can decrease the AMI risk in SCI patients.

Language: en