title: Mycoplasma pneumonia increases the risk of acute coronary syndrome: a nationwide population-based cohort study.
abstract: BACKGROUND
  Studies investigating the epidemiological relationship between Mycoplasma pneumonia (MP) and the subsequent development of acute coronary syndrome (ACS) are scant. We conducted a nationwide longitudinal cohort study in Taiwan to explore whether MP patients are at an increased risk of developing ACS.
  
  
  METHODS
  This study investigated the incidence and risk factors for ACS in 12 152 newly diagnosed MP patients from the Taiwan National Health Insurance Research Database between 2004 and 2011. The control group consisted of 48 600 individuals without MP. The follow-up period ran from the time of initial MP diagnosis to the date of an ACS event, censoring, or 31 December 2011. We analyzed the risk of ACS by using Cox proportional hazard regression models, including variables for sex, age and comorbidities.
  
  
  RESULTS
  The incidence of ACS was higher in MP patients than in comparison cohort (3.08 vs. 2.42 per 1000 person-years). The hazard ratio of developing ACS increased 37% in MP patients compared with that in the comparison cohort after adjustment for covariates. The effect of MP on subsequent ACS development appeared to 12 months after infection.
  
  
  CONCLUSIONS
  This nationwide study determined that compared with the general population, MP patients exhibited a 37% increase in the risk of subsequently developing ACS. Clinicians should be aware of this risk in MP patients and provide appropriate cardiovascular management in addition to MP treatment.
authors.affiliation: From the Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Department of Health Services Administration, China Medical University, Department of Healthcare Administration, Central Taiwan University of Science and Technology.
authors.forename: W-S
authors.initials: WS
authors.lastname: Chung
authors.affiliation: Department of Respiratory and Critical Care, China Medical University Hospital, Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University.
authors.forename: W-H
authors.initials: WH
authors.lastname: Hsu
authors.affiliation: Management Office for Health Data, China Medical University Hospital, College of Medicine, China Medical University and.
authors.forename: C-L
authors.initials: CL
authors.lastname: Lin
authors.affiliation: Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan d10040@mail.cmuh.org.tw.
authors.forename: C-H
authors.initials: CH
authors.lastname: Kao
mesh_terms: D054058:Acute Coronary Syndrome / Q000453:epidemiology / Q000209:etiology*; D000328:Adult; D017677:Age Distribution; D000368:Aged; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011019:Pneumonia, Mycoplasma / Q000150:complications* / Q000453:epidemiology; D017678:Sex Distribution; D013624:Taiwan / Q000453:epidemiology