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Increased risk of acute coronary syndrome among leptospirosis patients: A nationwide cohort analysis.
Int J Cardiol. 2015 Apr 01; 184:576-80.IJ

Abstract

BACKGROUND

Studies on the association between leptospirosis and acute coronary syndrome (ACS) are lacking. Therefore, this study identifies the effects of leptospirosis on the risks of developing ACS with a nationwide retrospective cohort study.

METHODS

We identified adult patients aged ≥20 years who were newly diagnosed with leptospirosis. We also randomly selected a comparison cohort from the general population by using a propensity score matching method. We analyzed the risks of ACS by using Cox proportional hazard regression models.

RESULTS

Among the 23.74 million people in the cohort, 3690 patients with leptospirosis (68% men, mean age of 52.2 years) and 3690 controls were followed for 13,677 and 15,652 person-years, respectively. The overall incidence of ACS was higher in the leptospirosis cohort than in the nonleptospirosis cohort (4.68 vs 3.71 per 1000 person-years), with a hazard ratio (HR) of 1.69 (95% confidence interval [CI]=1.12-2.56). Men exhibited a 1.88-fold greater HR of ACS than women did (95% CI=1.20-2.94). The risk of developing ACS was highest for leptospirosis patients aged ≥65 years (HR=7, 51% CI=4.35-12.9) compared with patients aged ≤49 years.

CONCLUSION

Leptospirosis is not a previously identified risk factor for ACS. The findings of this nationwide retrospective cohort study indicate that leptospirosis may become an independent risk factor for ACS. Future research to investigate the mechanism is warranted.

Authors+Show Affiliations

Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan; Department of Health Services Administration, China Medical University, Taichung, Taiwan; Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan.Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan.Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan.Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan. Electronic address: d10040@mail.cmuh.org.tw.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25769002

Citation

Chung, Wei-Sheng, et al. "Increased Risk of Acute Coronary Syndrome Among Leptospirosis Patients: a Nationwide Cohort Analysis." International Journal of Cardiology, vol. 184, 2015, pp. 576-80.
Chung WS, Chu YH, Lin CL, et al. Increased risk of acute coronary syndrome among leptospirosis patients: A nationwide cohort analysis. Int J Cardiol. 2015;184:576-80.
Chung, W. S., Chu, Y. H., Lin, C. L., & Kao, C. H. (2015). Increased risk of acute coronary syndrome among leptospirosis patients: A nationwide cohort analysis. International Journal of Cardiology, 184, 576-80. https://doi.org/10.1016/j.ijcard.2015.03.021
Chung WS, et al. Increased Risk of Acute Coronary Syndrome Among Leptospirosis Patients: a Nationwide Cohort Analysis. Int J Cardiol. 2015 Apr 1;184:576-80. PubMed PMID: 25769002.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased risk of acute coronary syndrome among leptospirosis patients: A nationwide cohort analysis. AU - Chung,Wei-Sheng, AU - Chu,Yung-Hua, AU - Lin,Cheng-Li, AU - Kao,Chia-Hung, Y1 - 2015/03/04/ PY - 2014/06/22/received PY - 2015/03/01/revised PY - 2015/03/02/accepted PY - 2015/3/14/entrez PY - 2015/3/15/pubmed PY - 2016/2/9/medline KW - Acute coronary syndrome (ACS) KW - Leptospirosis KW - Nationwide cohort study SP - 576 EP - 80 JF - International journal of cardiology JO - Int. J. Cardiol. VL - 184 N2 - BACKGROUND: Studies on the association between leptospirosis and acute coronary syndrome (ACS) are lacking. Therefore, this study identifies the effects of leptospirosis on the risks of developing ACS with a nationwide retrospective cohort study. METHODS: We identified adult patients aged ≥20 years who were newly diagnosed with leptospirosis. We also randomly selected a comparison cohort from the general population by using a propensity score matching method. We analyzed the risks of ACS by using Cox proportional hazard regression models. RESULTS: Among the 23.74 million people in the cohort, 3690 patients with leptospirosis (68% men, mean age of 52.2 years) and 3690 controls were followed for 13,677 and 15,652 person-years, respectively. The overall incidence of ACS was higher in the leptospirosis cohort than in the nonleptospirosis cohort (4.68 vs 3.71 per 1000 person-years), with a hazard ratio (HR) of 1.69 (95% confidence interval [CI]=1.12-2.56). Men exhibited a 1.88-fold greater HR of ACS than women did (95% CI=1.20-2.94). The risk of developing ACS was highest for leptospirosis patients aged ≥65 years (HR=7, 51% CI=4.35-12.9) compared with patients aged ≤49 years. CONCLUSION: Leptospirosis is not a previously identified risk factor for ACS. The findings of this nationwide retrospective cohort study indicate that leptospirosis may become an independent risk factor for ACS. Future research to investigate the mechanism is warranted. SN - 1874-1754 UR - https://www.unboundmedicine.com/medline/citation/25769002/Increased_risk_of_acute_coronary_syndrome_among_leptospirosis_patients:_A_nationwide_cohort_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0167-5273(15)00259-4 DB - PRIME DP - Unbound Medicine ER -