Recurrence and Mortality Risks in Patients with First Incident Acute Stroke or Myocardial Infarction: A Longitudinal Study Using the Korean National Health Insurance Service Database
SCIE
SCOPUS
- Title
- Recurrence and Mortality Risks in Patients with First Incident Acute Stroke or Myocardial Infarction: A Longitudinal Study Using the Korean National Health Insurance Service Database
- Authors
- Park, Dougho; Kim, Mun-Chul; Hong, Daeyoung; Jeong, Yong-Suk; Kim, Hyoung Seop; Kim, Jong Hun
- Date Issued
- 2023-01
- Publisher
- MDPI AG
- Abstract
- Background: We aimed to identify the long-term risk of recurrence and mortality in patients who experienced acute ischemic stroke (AIS), acute myocardial infarction (AMI), or acute hemorrhagic stroke (AHS) using a population-level database. Methods: This retrospective cohort study included adults aged >= 55 years diagnosed with AIS, AMI, and AHS in the National Health Insurance Service Database between 2004 and 2007. The target outcomes were secondary AIS, AMI, AHS, and all-cause mortality. Predetermined covariates, such as age, sex, socioeconomic status, hypertension, diabetes, and dyslipidemia, were adjusted. Results: We included 151,181, 49,077, and 41,636 patients in the AIS, AHS, and AMI groups, respectively. The AMI (adjusted hazard ratio [aHR], 0.318; 95% confidence interval [CI], 0.306-0.330; p < 0.001) and AHS (aHR, 0.489; 95% CI, 0.472-0.506; p < 0.001) groups had a significantly lower risk of developing secondary AIS than the AIS group. The risk of developing secondary AMI was significantly lower in the AMI (aHR, 0.388; 95% CI, 0.348-0.433; p < 0.001) and AHS (aHR, 0.711; 95% CI, 0.640-0.790; p < 0.001) groups than in the AIS group. Initial AHS was a decisive risk factor for secondary AHS (aHR, 8.546; 95% CI, 8.218-8.887; p < 0.001). The AMI (aHR, 1.436; 95% CI, 1.412-1.461; p < 0.001) and AHS (aHR, 1.328; 95% CI, 1.309-1.348; p < 0.001) groups were associated with a significantly higher risk of long-term mortality than the AIS group. Conclusion: Our results elucidated that initial AIS was a significant risk factor for recurrent AIS and AMI; initial AHS was a decisive risk factor for developing secondary AHS. Further, AMI and AHS were more closely related to long-term mortality than AIS.
- URI
- https://oasis.postech.ac.kr/handle/2014.oak/123642
- DOI
- 10.3390/jcm12020568
- Article Type
- Article
- Citation
- Journal of Clinical Medicine, vol. 12, no. 2, 2023-01
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