肌萎缩侧索硬化症患者心肌梗死风险增加：韩国全国队列研究。
Increased risk of myocardial infarction in amyotrophic lateral sclerosis: A nationwide cohort study in South Korea.
机构信息
Department of Neurology, Inha University Hospital, Incheon, South, Republic of Korea; Department of Neurology, The Graduate School Sungkyunkwan University, Seoul, Republic of Korea.
Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea.
出版信息
J Neurol Sci. 2023 Nov 15;454:120829. doi: 10.1016/j.jns.2023.120829. Epub 2023 Oct 5.
BACKGROUND
The risk of myocardial infarction (MI), the major form of CVD, in amyotrophic lateral sclerosis (ALS) is currently unknown. We investigated the risk of MI in ALS and analyzed the effect of ALS-related physical disability on the risk of MI using the Korean National Health Insurance Service database.
METHODS
A total of 659 ALS patients and 10,927 non-ALS participants were finally selected between January 1, 2011, and December 31, 2015. A Cox hazard regression model was used to examine the hazard ratios (HRs) for MI in ALS after adjustment for potential confounders.
RESULTS
The incidence rate of MI was 26.2 per 1000 person-years, and the adjusted HR (aHR) for MI in ALS patients was 10.6 (95% confidence interval [CI] 7.2-15.4) compared with the controls. ALS patients who developed physical disability had an even higher risk of MI (aHR 18.6, 95% CI 11.5-30.0) compared with those who did not develop disability (aHR 7.4, 95% CI 4.6-11.9). The increased risk of MI was more prominent in female subjects than in male subjects (aHR 17.8, 95% CI 10.8-29.4 vs. aHR 6.9, 95% CI 4.1-11.6, P for interaction 0.006) and in obese subjects than in non-obese subjects (aHR 17.8, 95% CI 10.5-30.1 vs. aHR 7.9, 95% CI 4.9-12.8, P for interaction 0.018).
CONCLUSIONS
Our findings suggest that the risk of MI is high in ALS patients compared with a control population, and the risk is more prominent in those who develop physical disability, or who are female or obese.
背景
肌萎缩侧索硬化症（ALS）患者发生心肌梗死（MI）的风险（主要的心血管疾病形式）目前尚不清楚。我们利用韩国国家健康保险服务数据库，研究了 ALS 患者发生 MI 的风险，并分析了与 ALS 相关的身体残疾对 MI 风险的影响。
方法
2011 年 1 月 1 日至 2015 年 12 月 31 日期间，共纳入 659 例 ALS 患者和 10927 名非 ALS 参与者。使用 Cox 危害回归模型，在校正潜在混杂因素后，检查 ALS 患者 MI 的危害比（HR）。
结果
MI 的发生率为 26.2/1000 人年，与对照组相比，ALS 患者 MI 的调整 HR（aHR）为 10.6（95%置信区间[CI]7.2-15.4）。与未发生残疾的患者相比，发生身体残疾的 ALS 患者发生 MI 的风险更高（aHR 18.6，95%CI 11.5-30.0）（aHR 7.4，95%CI 4.6-11.9）。与男性相比，女性发生 MI 的风险增加更为显著（aHR 17.8，95%CI 10.8-29.4 比 aHR 6.9，95%CI 4.1-11.6，P 交互=0.006），与非肥胖者相比，肥胖者发生 MI 的风险增加更为显著（aHR 17.8，95%CI 10.5-30.1 比 aHR 7.9，95%CI 4.9-12.8，P 交互=0.018）。
结论
与对照组相比，ALS 患者发生 MI 的风险较高，且发生身体残疾或为女性或肥胖者，其风险更为显著。
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