Liu Xin, Wang Aitian, Liu Tao, Li Yue, Chen Shuohua, Wu Shouling, Fan Haojun, Gao Jingli, Li Xiaolan, Hou Shike, Cao Chunxia
Institute of Disaster and Emergency Medicine, Tianjin University, 300072 Tianjin, China.
Department of Intensive Medicine, Kailuan General Hospital, 063001 Tangshan, Hebei, China.
Rev Cardiovasc Med. 2023 Apr 28;24(5):136. doi: 10.31083/j.rcm2405136. eCollection 2023 May.
Several studies have linked traumatic injury and cardiovascular disease. However, few studies have investigated the associations between traumatic injury and cardiovascular disease subtypes. We aimed to prospectively examine the association between traumatic injury and the risk of incident myocardial infarction (MI) and stroke.
This study was based on a prospective cohort study that included 13,973 patients who had been hospitalized for traumatic injuries from 1980 to 2020. We randomly selected 4 uninjured participants from the cohort study for each patient as controls matched by age ( 3 years) and sex. All participants were free of MI and stroke at enrollment. Cox regression was used to examine the association between traumatic injury and incident MI and stroke.
During a median follow-up period of 13.5 years, 1032 cases of MI and 4068 cases of stroke were recorded. After multivariable adjustment, relative to controls, patients with severe injury had the highest hazard ratio (HR) for MI (HR = 1.93; 95% CI: 1.26-2.96) and stroke (HR = 1.60; 95% CI: 1.25-2.05). The HRs of MI and stroke were 0.97 (0.81-1.17) and 1.11 (1.02-1.21) for patients with mild injury and 1.28 (0.97-1.69) and 1.22 (1.06 to 1.41) for patients with moderate injury. Additionally, patients with older age at injury and chest injury had a higher HR for MI and stroke (-interaction 0.05).
Traumatic injury appears to be associated with an increased risk of incident MI and stroke. Therefore, early screening and prevention of MI and stroke following a traumatic injury are needed.
多项研究已将创伤性损伤与心血管疾病联系起来。然而，很少有研究调查创伤性损伤与心血管疾病亚型之间的关联。我们旨在前瞻性地研究创伤性损伤与心肌梗死（MI）和中风发病风险之间的关联。
本研究基于一项前瞻性队列研究，该研究纳入了1980年至2020年因创伤性损伤住院的13973名患者。我们从队列研究中为每位患者随机选取4名未受伤的参与者作为对照，按年龄（±3岁）和性别进行匹配。所有参与者在入组时均无MI和中风。采用Cox回归分析创伤性损伤与MI和中风发病之间的关联。
在中位随访期13.5年期间，记录到1032例MI和4068例中风病例。多变量调整后，与对照组相比，重伤患者发生MI（风险比[HR]=1.93；95%置信区间[CI]：1.26 - 2.96）和中风（HR = 1.60；95% CI：1.25 - 2.05）的风险比最高。轻伤患者发生MI和中风的HR分别为0.97（0.81 - 1.17）和1.11（1.02 - 1.21），中度伤患者分别为1.28（0.97 - 1.69）和1.22（1.06至1.41）。此外，受伤时年龄较大和胸部受伤的患者发生MI和中风的HR更高（交互作用P<0.05）。
创伤性损伤似乎与MI和中风发病风险增加有关。因此，创伤后需要对MI和中风进行早期筛查和预防。
