Department of Emergency Medicine, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea.
Department of Ophthalmology, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea.
Sci Rep. 2021 May 6;11(1):9696. doi: 10.1038/s41598-021-89038-1.
It is well established that the risk of acute coronary syndrome (ACS) increases after respiratory infection. However, the reverse association has not been evaluated. We tested the hypothesis that the long-term risk of pneumonia is increased after a new ACS event. A matched-cohort study was conducted using a nationally representative dataset. We identified patients with admission for ACS between 2004 and 2014, without a previous history of ACS or pneumonia. Incidence density sampling was used to match patients, on the basis of age and sex, to 3 controls who were also free from both ACS and pneumonia. We examined the incidence of pneumonia after ACS until the end of the cohort observation (Dec 31, 2014). The analysis cohort consisted of 5469 ACS cases and 16,392 controls (median age, 64 years; 68.3% men). The incidence rate ratios of the first and the total pneumonia episodes in the ACS group relative to the control group was 1.25 (95% confidence interval [CI], 1.11-1.41) and 1.23(95% CI 1.11-1.36), respectively. A significant ACS-related increase in the incidence of pneumonia was observed in the Cox-regression, shared frailty, and joint frailty model analyses, with hazard ratios of 1.25 (95% CI 1.09-1.42), 1.35 (95% CI 1.15-1.58), and 1.24 (95% CI 1.10-1.39), respectively. In this population-based cohort of patients who were initially free from both ACS and pneumonia, we found that hospitalization for ACS substantially increased the long term risk of pneumonia. This should be considered when formulating post-discharge care plans and preventive vaccination strategies in patients with ACS.
众所周知，呼吸道感染后急性冠状动脉综合征（ACS）的风险会增加。然而，尚未评估相反的关联。我们检验了这样一个假设，即在发生新的 ACS 事件后，肺炎的长期风险会增加。本研究采用全国代表性数据集进行了匹配队列研究。我们确定了 2004 年至 2014 年期间因 ACS 入院但无 ACS 或肺炎既往病史的患者。基于年龄和性别，采用发病率密度抽样法对患者进行匹配，以匹配无 ACS 和肺炎的 3 名对照者。我们检查了 ACS 后肺炎的发病情况，直至队列观察结束（2014 年 12 月 31 日）。分析队列包括 5469 例 ACS 病例和 16392 例对照者（中位年龄 64 岁；68.3%为男性）。ACS 组与对照组相比，首次和总肺炎发作的发生率比值比分别为 1.25（95%可信区间 [CI]，1.11-1.41）和 1.23（95%CI 1.11-1.36）。在 Cox 回归、共享脆弱性和联合脆弱性模型分析中，均观察到 ACS 与肺炎发病率显著相关增加，风险比分别为 1.25（95%CI 1.09-1.42）、1.35（95%CI 1.15-1.58）和 1.24（95%CI 1.10-1.39）。在这个最初无 ACS 和肺炎的患者的基于人群的队列中，我们发现 ACS 住院治疗大大增加了长期患肺炎的风险。在制定 ACS 患者出院后护理计划和预防接种策略时，应考虑到这一点。
