title: Parkinson disease and risk of acute myocardial infarction: A population-based, propensity score-matched, longitudinal follow-up study.
abstract: OBJECTIVE
  Previous studies on the risk of acute myocardial infarction (AMI) in patients with Parkinson disease (PD) have generated inconsistent results. The purpose of this population-based longitudinal follow-up study was to investigate whether incident PD is associated with an increased risk of AMI.
  
  
  METHODS
  A total of 3,211 subjects with at least 2 ambulatory visits with the principal diagnosis of PD in 2001 were enrolled in the PD group. The non-PD group consisted of 3,211 propensity score-matched subjects without PD. The propensity scores were computed using a logistic regression model that included age, sex, preexisting comorbidities, and socioeconomic status. The 3-year AMI-free survival rates of the 2 groups were estimated using the Kaplan-Meier method. Stratified Cox proportional hazard regression with patients matched by propensity score was used to estimate the effect of PD on subsequent occurrence of AMI.
  
  
  RESULTS
  During the 3-year follow-up period, 83 subjects in the PD group and 53 in the non-PD group developed AMI (either fatal or nonfatal) events. The hazard ratio of AMI for the PD group compared with the non-PD group was 1.67 (95% CI 1.15-2.41, P = .0067). The AMI-free survival rate of the PD group was significantly lower than that of the non-PD group (P = .0032). The hazard ratios associated with PD for the combined end point 1 (AMI or cardiovascular death) and combined end point 2 (AMI or all-cause death) were 1.46 (95% CI 1.14-1.88, P = .0029) and 1.42 (95% CI 1.24-1.64, P < .0001), respectively.
  
  
  CONCLUSIONS
  This study shows that PD is related to an increased risk of AMI. Further studies are required to investigate the mechanism underlying this association.
authors.affiliation: Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Huey-Wen
authors.initials: HW
authors.lastname: Liang
authors.affiliation: Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan.
authors.forename: Ya-Ping
authors.initials: YP
authors.lastname: Huang
authors.affiliation: Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: panslcb@gmail.com.
authors.forename: Shin-Liang
authors.initials: SL
authors.lastname: Pan
mesh_terms: D000368:Aged; D002423:Cause of Death / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000209:etiology*; D010300:Parkinson Disease / Q000150:complications*; D011159:Population Surveillance / Q000379:methods*; D011379:Prognosis; D057216:Propensity Score; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013624:Taiwan / Q000453:epidemiology