Keller Joseph J, Wu Chuan-Song, Kang Jiunn-Horng, Lin Herng-Ching
School of Public Health, Taipei Medical University, Taipei, Taiwan, ROC.
Audiol Neurootol. 2013;18(1):3-8. doi: 10.1159/000341988. Epub 2012 Aug 30.
Although the etiology of sudden sensorineural hearing loss (SSNHL) remains unknown, there is increasing evidence suggesting an underlying cardiovascular pathomechanism. This study set out to explore a possible association between acute myocardial infarction (AMI) and having previously been diagnosed with SSNHL by using a population-based dataset with a case-control design.
In this study, we utilized administrative claims data from the Taiwan National Health Insurance program to identify 48,674 cases with AMI and to randomly select 243,370 controls. Conditional logistic regression was used to explore the association between AMI and having previously been diagnosed with SSNHL.
Of the sampled patients, 1,313 (0.4%) had been diagnosed with SSNHL within 5 years before the index date; 340 (0.75% of the cases) were from the cases and 974 (0.4% of controls) were from the controls. After adjusting for patient geographic region, monthly income, hypertension, diabetes, hyperlipidemia, and coronary heart disease, conditional logistic regression analysis (conditioned on sex, age group, urbanization level, and index date) revealed that the odds ratio for prior SSNHL in patients with AMI was 1.50 (95% CI 1.30-1.70; p < 0.001) that of controls. We found that the adjusted odds ratio of prior hospitalization for the treatment of SSNHL for cases was 2.11 (95% CI 1.65-2.69; p < 0.001) times that of controls.
This study identified a novel association between AMI and prior SSNHL. The results of this study highlight a need for clinicians dealing with SSNHL patients to be alert to their risk of subsequent AMI.
尽管突发性感音神经性听力损失(SSNHL)的病因尚不清楚,但越来越多的证据表明存在潜在的心血管发病机制。本研究旨在通过使用基于人群的病例对照设计数据集,探讨急性心肌梗死(AMI)与先前被诊断为SSNHL之间的可能关联。
在本研究中,我们利用台湾国民健康保险计划的行政索赔数据,确定了48,674例AMI病例,并随机选择了243,370名对照。采用条件逻辑回归分析来探讨AMI与先前被诊断为SSNHL之间的关联。
在抽样患者中,1313例(0.4%)在索引日期前5年内被诊断为SSNHL;其中340例(占病例的0.75%)来自病例组,974例(占对照组的0.4%)来自对照组。在调整了患者的地理区域及月收入、高血压、糖尿病、高脂血症和冠心病等因素后,条件逻辑回归分析(按性别、年龄组、城市化水平和索引日期进行条件设定)显示,AMI患者先前患SSNHL的比值比为1.50(95%置信区间1.30 - 1.70;p < 0.001),是对照组的1.50倍。我们发现,病例组先前因治疗SSNHL而住院的调整后比值比是对照组的2.11倍(95%置信区间1.65 - 2.69;p < 0.001)。
本研究发现了AMI与先前SSNHL之间的新关联。本研究结果强调,处理SSNHL患者的临床医生需要警惕其随后发生AMI的风险。