From the Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Department of Health Services Administration, China Medical University, Department of Healthcare Administration, Central Taiwan University of Science and Technology.
Department of Respiratory and Critical Care, China Medical University Hospital, Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University.
QJM. 2015 Sep;108(9):697-703. doi: 10.1093/qjmed/hcv015. Epub 2015 Jan 21.
Studies investigating the epidemiological relationship between Mycoplasma pneumonia (MP) and the subsequent development of acute coronary syndrome (ACS) are scant. We conducted a nationwide longitudinal cohort study in Taiwan to explore whether MP patients are at an increased risk of developing ACS.
This study investigated the incidence and risk factors for ACS in 12 152 newly diagnosed MP patients from the Taiwan National Health Insurance Research Database between 2004 and 2011. The control group consisted of 48 600 individuals without MP. The follow-up period ran from the time of initial MP diagnosis to the date of an ACS event, censoring, or 31 December 2011. We analyzed the risk of ACS by using Cox proportional hazard regression models, including variables for sex, age and comorbidities.
The incidence of ACS was higher in MP patients than in comparison cohort (3.08 vs. 2.42 per 1000 person-years). The hazard ratio of developing ACS increased 37% in MP patients compared with that in the comparison cohort after adjustment for covariates. The effect of MP on subsequent ACS development appeared to 12 months after infection.
This nationwide study determined that compared with the general population, MP patients exhibited a 37% increase in the risk of subsequently developing ACS. Clinicians should be aware of this risk in MP patients and provide appropriate cardiovascular management in addition to MP treatment.
研究支原体肺炎(MP)与急性冠状动脉综合征(ACS)之间的流行病学关系的研究很少。我们在台湾进行了一项全国性的纵向队列研究,以探讨 MP 患者是否有发展为 ACS 的风险增加。
本研究调查了 2004 年至 2011 年间台湾国家健康保险研究数据库中 12152 例新诊断为 MP 的患者的 ACS 发生率和危险因素。对照组由 48600 名无 MP 的个体组成。随访期从首次 MP 诊断开始到 ACS 事件、截止或 2011 年 12 月 31 日。我们使用 Cox 比例风险回归模型分析 ACS 的风险,包括性别、年龄和合并症等变量。
MP 患者的 ACS 发生率高于对照组(3.08 比 2.42/1000人年)。调整协变量后,MP 患者发生 ACS 的风险比对照组增加 37%。MP 对随后 ACS 发展的影响似乎在感染后 12 个月出现。
这项全国性研究表明,与一般人群相比,MP 患者发生 ACS 的风险增加了 37%。临床医生应意识到 MP 患者存在这种风险,并在治疗 MP 的基础上提供适当的心血管管理。