Increased Risk of Acute Coronary Syndrome in Patients With Diverticular Disease

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Title:	Increased Risk of Acute Coronary Syndrome in Patients With Diverticular Disease
Authors:	Jiun-Nong Lin;Cheng-Li Lin;Chih-Hui Yang;Ming-Chia Lin;Chung-Hsu Lai;Hsi-Hsun Lin;Chia-Hung Kao
Date:	2015-11
Issue Date:	2016-04-12T07:09:13Z (UTC)
Abstract:	Abstract: Diverticular disease and acute coronary syndrome (ACS)are common disorders that share several risk factors. Few researchershave 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 analyzingdata from the National Health Insurance Research Database inTaiwan. All patients aged 20 years with a diagnosis of diverticulardisease from January 1, 2000, to December 31, 2011, were included inthis study. For comparison, patients without diverticular disease wererandomly selected and matched with the study cohort at a 4:1 ratioaccording to age, sex, and the year of the diagnosis of diverticulardisease. Patients with incomplete age or sex information and a history ofcardiovascular diseases were excluded from the study. All patients were followed until an ACS event, withdrawal from the insurance program, orDecember 31, 2011.In this study, 52,681 patients with diverticular disease and 210,724patients without diverticular disease were included. Men accounted for56.1% of patients and 57.8% of patients were 50 years old. The overallincidence density of ACS in patients with diverticular disease (45.5 per10,000 person-years) was significantly higher than in those withoutdiverticular disease (30.3 per 10,000 person-years), with an adjustedhazard ratio (HR) of 1.23 (95% confidence interval [CI], 1.14–1.32)after adjustment for age, sex, and comorbidities. The cumulativeincidence of ACS in patients with diverticular disease was significantlyhigher than that in the control cohort (log-rank test, P<0.001). Theadjusted 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 anddiverticulosis, respectively. The adjusted HRs of ACS in patients withdiverticular 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) inthose with 5 comorbidities.This large population-based retrospective study revealed an associationbetween diverticular disease and ACS. Further research is warrantedto determine the exact mechanism of the link between thesediseases.(Medicine 94(45):e2020)
Relation:	Medicine Volume 94, Number 45, November 2015
Appears in Collections:	[General Education Center] Papers

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