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Risks of acute coronary syndrome in patients with osteoarthritis: a nationwide population-based cohort study

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Abstract

Recent studies have reported that osteoarthritis (OA) is related to inflammation and atherosclerosis. Studies on the relationship between OA and acute coronary syndrome (ACS) are scant. We evaluated the risk of ACS in OA patients of an Asian population. This longitudinal, population-based cohort study investigated the incidence and risk of ACS in 46,042 patients with newly diagnosed OA and 46,042 controls selected randomly from the general population and frequency matched according to age, sex, and entry year (2002–2003). The follow-up period ranged from the entry date until the date of an ACS event, loss to follow-up, or the end of 2010. We employed Cox proportional hazard models to estimate the effects of OA on the risk of ACS. The OA patients showed a 15 % higher risk of ACS than did the controls after adjustment for covariates (adjusted hazard ratio [aHR] = 1.15, 95 % confidence interval [CI] = 1.08–1.23). The risk of ACS in the OA patients was the greatest in young adults (aHR = 2.0, 95 % CI = 1.44–2.78), followed by middle-aged (aHR = 1.15, 95 % CI = 1.01–1.31) and older adults (aHR = 1.11, 95 % CI = 1.03–1.20). The risk of ACS was 1.96-fold in young adults with mild to moderate OA and 3.51-fold in young adults with severe OA compared with their counterparts without OA. OA carries an increased risk of ACS, particularly in young adults with severe OA. Clinicians should employ proactive strategies for preventing ACS occurrence in these patients.

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Acknowledgments

This work did not apply for external funding. We acknowledged the administrative support from Taichung Hospital and Central Taiwan University of Science and Technology.

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Authors and Affiliations

  1. Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, No. 199, Section 1, San-Min Road, Taichung, 40343, Taiwan

    Wei-Sheng Chung

  2. Department of Health Services Administration, China Medical University, Taichung, Taiwan

    Wei-Sheng Chung

  3. Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan

    Wei-Sheng Chung

  4. Department of Management Information Systems, Central Taiwan University of Science and Technology, Taichung, Taiwan

    Hsuan-Hung Lin

  5. Department of Internal Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan

    Feng-Ming Ho

  6. Department of Physical Medicine and Rehabilitation, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan

    Chung-Liang Lai

  7. Department of Internal Medicine, Lotung Poh-Ai Hospital, Yilan, Taiwan

    Chia-Lun Chao

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  1. Wei-Sheng Chung
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  2. Hsuan-Hung Lin
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Correspondence to Wei-Sheng Chung.

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Authors’ contributions

All authors have contributed significantly to this work and all authors are in agreement with the content of the manuscript. Conception/design: Wei-Sheng Chung, collection and/or assembly of data: all authors, data analysis and interpretation: Wei-Sheng Chung and Hsuan-Hung Lin, manuscript writing and final approval of manuscript: all authors.

Key message

1. The risk of ACS in the OA patients was 2.0-fold in young adults, followed by 1.15-fold in middle-aged and 1.11-fold in older adults.

2. The risk of ACS was 1.96-fold in young adults with mild to moderate OA.

3. The young adults with severe OA carried a 3.51-fold risk of ACS.

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Chung, WS., Lin, HH., Ho, FM. et al. Risks of acute coronary syndrome in patients with osteoarthritis: a nationwide population-based cohort study. Clin Rheumatol 35, 2807–2813 (2016). https://doi.org/10.1007/s10067-016-3391-x

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  • DOI: https://doi.org/10.1007/s10067-016-3391-x

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