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Increased Risk of Acute Coronary Syndrome in Patients With Diverticular Disease: A Nationwide Population-Based Study.
Medicine (Baltimore). 2015 Nov; 94(45):e2020.M

Abstract

Diverticular disease and acute coronary syndrome (ACS) are common disorders that share several risk factors. Few researchers have evaluated the association between diverticular disease and ACS. We aimed to assess the risk of ACS in patients with diverticular disease. A nationwide retrospective cohort study was conducted by analyzing data from the National Health Insurance Research Database in Taiwan. All patients aged ≥20 years with a diagnosis of diverticular disease from January 1, 2000, to December 31, 2011, were included in this study. For comparison, patients without diverticular disease were randomly selected and matched with the study cohort at a 4:1 ratio according to age, sex, and the year of the diagnosis of diverticular disease. Patients with incomplete age or sex information and a history of cardiovascular diseases were excluded from the study. All patients were followed until an ACS event, withdrawal from the insurance program, or December 31, 2011. In this study, 52,681 patients with diverticular disease and 210,724 patients without diverticular disease were included. Men accounted for 56.1% of patients and 57.8% of patients were ≥50 years old. The overall incidence density of ACS in patients with diverticular disease (45.5 per 10,000 person-years) was significantly higher than in those without diverticular disease (30.3 per 10,000 person-years), with an adjusted hazard ratio (HR) of 1.23 (95% confidence interval [CI], 1.14-1.32) after adjustment for age, sex, and comorbidities. The cumulative incidence of ACS in patients with diverticular disease was significantly higher than that in the control cohort (log-rank test, P < 0.001). The adjusted HRs for the development of ACS were 1.25 (95% CI, 1.15-1.37) and 1.19 (95% CI, 1.07-1.32) in patients with diverticulitis and diverticulosis, respectively. The adjusted HRs of ACS in patients with diverticular disease additionally increased from 1.97 (95% CI, 1.73-2.23) in patients with 1 comorbidity to 5.51 (95% CI, 3.88-7.84) in those with ≥5 comorbidities. This large population-based retrospective study revealed an association between diverticular disease and ACS. Further research is warranted to determine the exact mechanism of the link between these diseases.

Authors+Show Affiliations

From the Department of Critical Care Medicine (JNL), Division of Infectious Diseases, Department of Internal Medicine (JNL, CHL, HHL), Department of Nuclear Medicine (MCL), E-Da Hospital, I-Shou University, Kaohsiung, Taiwan; School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan (JNL), Management Office for Health Data (CLL), Department of Nuclear Medicine and PET Center (CHK), China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Clinical Medical Science and School of Medicine (CHK), College of Medicine, China Medical University, Taichung, Taiwan (CLL); and General Education Center, Meiho University, Pingtung, Taiwan (CHY).No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

26559302

Citation

Lin, Jiun-Nong, et al. "Increased Risk of Acute Coronary Syndrome in Patients With Diverticular Disease: a Nationwide Population-Based Study." Medicine, vol. 94, no. 45, 2015, pp. e2020.
Lin JN, Lin CL, Yang CH, et al. Increased Risk of Acute Coronary Syndrome in Patients With Diverticular Disease: A Nationwide Population-Based Study. Medicine (Baltimore). 2015;94(45):e2020.
Lin, J. N., Lin, C. L., Yang, C. H., Lin, M. C., Lai, C. H., Lin, H. H., & Kao, C. H. (2015). Increased Risk of Acute Coronary Syndrome in Patients With Diverticular Disease: A Nationwide Population-Based Study. Medicine, 94(45), e2020. https://doi.org/10.1097/MD.0000000000002020
Lin JN, et al. Increased Risk of Acute Coronary Syndrome in Patients With Diverticular Disease: a Nationwide Population-Based Study. Medicine (Baltimore). 2015;94(45):e2020. PubMed PMID: 26559302.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased Risk of Acute Coronary Syndrome in Patients With Diverticular Disease: A Nationwide Population-Based Study. AU - Lin,Jiun-Nong, AU - Lin,Cheng-Li, AU - Yang,Chih-Hui, AU - Lin,Ming-Chia, AU - Lai,Chung-Hsu, AU - Lin,Hsi-Hsun, AU - Kao,Chia-Hung, PY - 2015/11/13/entrez PY - 2015/11/13/pubmed PY - 2016/2/26/medline SP - e2020 EP - e2020 JF - Medicine JO - Medicine (Baltimore) VL - 94 IS - 45 N2 - Diverticular disease and acute coronary syndrome (ACS) are common disorders that share several risk factors. Few researchers have evaluated the association between diverticular disease and ACS. We aimed to assess the risk of ACS in patients with diverticular disease. A nationwide retrospective cohort study was conducted by analyzing data from the National Health Insurance Research Database in Taiwan. All patients aged ≥20 years with a diagnosis of diverticular disease from January 1, 2000, to December 31, 2011, were included in this study. For comparison, patients without diverticular disease were randomly selected and matched with the study cohort at a 4:1 ratio according to age, sex, and the year of the diagnosis of diverticular disease. Patients with incomplete age or sex information and a history of cardiovascular diseases were excluded from the study. All patients were followed until an ACS event, withdrawal from the insurance program, or December 31, 2011. In this study, 52,681 patients with diverticular disease and 210,724 patients without diverticular disease were included. Men accounted for 56.1% of patients and 57.8% of patients were ≥50 years old. The overall incidence density of ACS in patients with diverticular disease (45.5 per 10,000 person-years) was significantly higher than in those without diverticular disease (30.3 per 10,000 person-years), with an adjusted hazard ratio (HR) of 1.23 (95% confidence interval [CI], 1.14-1.32) after adjustment for age, sex, and comorbidities. The cumulative incidence of ACS in patients with diverticular disease was significantly higher than that in the control cohort (log-rank test, P < 0.001). The adjusted HRs for the development of ACS were 1.25 (95% CI, 1.15-1.37) and 1.19 (95% CI, 1.07-1.32) in patients with diverticulitis and diverticulosis, respectively. The adjusted HRs of ACS in patients with diverticular disease additionally increased from 1.97 (95% CI, 1.73-2.23) in patients with 1 comorbidity to 5.51 (95% CI, 3.88-7.84) in those with ≥5 comorbidities. This large population-based retrospective study revealed an association between diverticular disease and ACS. Further research is warranted to determine the exact mechanism of the link between these diseases. SN - 1536-5964 UR - https://www.unboundmedicine.com/medline/citation/26559302/Increased_Risk_of_Acute_Coronary_Syndrome_in_Patients_With_Diverticular_Disease:_A_Nationwide_Population_Based_Study_ L2 - http://dx.doi.org/10.1097/MD.0000000000002020 DB - PRIME DP - Unbound Medicine ER -