Chang Ju-Hsin, Shen Te-Chun, Chen Ke-Wei, Lin Cheng-Li, Hsu Chung Y, Wen Yeong-Ray, Chang Kuan-Cheng
Graduate Institute of Clinical Medicine Science, China Medical University, No. 91, Xue-Shi Road, Taichung 404, Taiwan.
Department of Anesthesia, China Medical University Hospital, Taichung 404, Taiwan.
Biomedicines. 2023 Mar 14;11(3):897. doi: 10.3390/biomedicines11030897.
Pneumoconiosis (PCN) has several comorbidities, most notably pulmonary and cardiovascular diseases. However, much is still unknown about the relationship between PCN and acute myocardial infarction (AMI). The present study aimed to clarify the association between PCN and subsequent AMI risk using a retrospective cohort study design.
This was a population-based, retrospective cohort study that used data from Taiwan's National Health Insurance Database. A total of 7556 newly diagnosed patients with PCN and 7556 individuals without PCN were included in the PCN and comparison cohort (PC and CC), respectively, between 2008 and 2018, with propensity score matching for age, gender, comorbidity, medication, and date of PCN diagnosis. The occurrence of AMI was monitored until the end of 2019, and AMI risk was assessed using Cox proportional hazard regression models.
The overall incidence of AMI was 1.34-fold higher in the PC than in the CC (4.33 vs. 3.23 per 1000 person-years, respectively, < 0.05), with an adjusted hazard ratio (aHR) of 1.36 (95% confidence interval (CI): 1.08-1.72) after controlling for age, gender, comorbidity, and medication. Further analyses showed a higher risk of AMI with increased annual number of emergency department visits among patients with PCN (aHR: 1.30, 95% CI: 1.01-1.66 (<1) and aHR: 1.68, 95% CI: 1.13-2.50 (≥1)).
Patients with PCN had a significantly higher risk of developing AMI than those without PCN. Clinicians should pay more attention to prevent AMI episodes in patients with PCN.
尘肺病（PCN）有多种合并症，最显著的是肺部和心血管疾病。然而，关于PCN与急性心肌梗死（AMI）之间的关系仍有许多未知之处。本研究旨在采用回顾性队列研究设计，阐明PCN与后续AMI风险之间的关联。
这是一项基于人群的回顾性队列研究，使用了台湾国民健康保险数据库的数据。2008年至2018年期间，分别有7556例新诊断的PCN患者和7556例无PCN的个体被纳入PCN队列和对照队列（PC和CC），并根据年龄、性别、合并症、用药情况和PCN诊断日期进行倾向得分匹配。监测AMI的发生直至2019年底，并使用Cox比例风险回归模型评估AMI风险。
PC队列中AMI的总体发病率比CC队列高1.34倍（分别为每千人年4.33例和3.23例，<0.05），在控制年龄、性别、合并症和用药情况后，调整后的风险比（aHR）为1.36（95%置信区间（CI）：1.08 - 1.72）。进一步分析显示，PCN患者中，随着急诊科就诊年度次数增加，AMI风险更高（aHR：1.30，95%CI：1.01 - 1.66（<1次）和aHR：1.68，95%CI：1.13 - 2.50（≥1次））。
PCN患者发生AMI的风险显著高于无PCN的患者。临床医生应更加关注预防PCN患者发生AMI。
