An association between autosomal-dominant polycystic kidney disease and the risk of acute myocardial infarction in Asian population — results of a nationwide study
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Pei-Hsun Sung1, Hsin-Ju Chiang2, Yao-Hsu Yang3,4,5, Chi-Jen Chen5, John Y. Chiang6,7, Hon-Kan Yip1,8,9,10
1Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
2Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
3Department for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan
4Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan
5Center of Excellence for Chang Gung Research Datalink, Chang Gung Memorial Hospital, Chiayi, Taiwan
6Department of Computer Science and Engineering, National Sun Yat-Sen University, Kaohsiung, Taiwan
7Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan
8Institute for Translational Research in Biomedicine, Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
9Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
10Department of Nursing, Asia University, Taichung, Taiwan
Hon-Kan Yip, email: [email protected]
Keywords: autosomal-dominant polycystic kidney disease, acute myocardial infarction, Asian, Taiwanese, population-based cohort study
Received: August 24, 2016 Accepted: December 01, 2016 Published: December 27, 2016
Cardiovascular complications are the leading causes of death in patients with autosomal-dominant polycystic kidney disease (ADPKD) in the Western countries. However, theprevalence and risk of acute myocardial infarction (AMI) in patients with ADPKD remain unknown, especially in Asian population. We utilized the data from Taiwan National Health Insurance Research Database (NHIRD) to perform a population-based cohort study (1997-2008). A total of 2062 patients with ADPKD were selected from one million of general population after excluding those patients with age less than 18 years old, receiving renal replacement therapy, and concomitant diagnoses of AMI. Additionally, we set up those patients without ADPKD as comparison group by matching study cohort with age, gender, income and urbanization with 1:10 ratio (n=20620). The results showed that although the prevalence of AMI in ADPKD patients in Taiwan was lower than those in the United States (2.91% v.s. 6%, p=0.0567), the Taiwanese ADPKD group had significantly higher prevalence of AMI as compared with the non-ADPKD group (2.91% v.s. 0.97%, p<0.0001). In addition, Kaplan-Meier analysis demonstrated that cumulative incidence of AMI was significantly higher in ADPKD than in the non-ADPKD group (all p<0.001). After adjusting for age, gender and comorbidities by multivariate and sensitivity analysis, ADPKD patients had 2.43-fold greater risk for developing AMI as compared with non-ADPKD patients (95% CI 1.8 to 3.29, p<0.0001). In conclusion, Taiwanese patients with ADPKD have lower prevalence of AMI as compared to Americans, whereas ADPKD per se remains independently predictive of AMI in Asian population.
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