Decreased risk of acute myocardial infarction in stroke patients receiving acupuncture treatment: a nationwide matched retrospective cohort study.
BACKGROUND
Whether acupuncture protects stroke patients from acute myocardial infarction (AMI) has not been studied previously. The purpose of this study was to investigate the risk of AMI among stroke patients receiving acupuncture treatment.


METHODS
Taiwan's National Health Insurance Research Database was used to conduct a retrospective cohort study of 23475 stroke patients aged 40-79 years receiving acupuncture treatment and 46950 propensity score-matched stroke patients not receiving acupuncture treatment who served as controls from 2000 to 2004. Both stroke cohorts were followed until the end of 2009 and were adjusted for immortal time to measure the incidence and adjusted hazard ratios (HRs) with 95 % confidence intervals (CIs) for new-onset AMI in multivariate Cox proportional hazard models.


RESULTS
Stroke patients who received acupuncture treatment (9.2 per 1000 person-years) exhibited a lower incidence of AMI compared with those who did not receive acupuncture treatment (10.8 per 1000 person-years), with an HR of 0.86 (95 % CI, 0.80-0.93) after adjusting for age, sex, low income, coexisting medical conditions and medications. The relationship between acupuncture treatment and AMI risk was investigated in female stroke patients (HR, 0.85; 95 % CI, 0.76-0.95), male stroke patients (HR, 0.87; 95 % CI, 0.80-0.95), patients from 50 to 59 years of age (HR, 0.75; 95 % CI, 0.63-0.90), patients from 60 to 69 years of age (HR, 0.85; 95 % CI, 0.75-0.95), patients suffering from ischemic stroke (HR, 0.87; 95 % CI, 0.79-0.95), and patients suffering from hemorrhagic stroke (HR, 0.62; 95 % CI, 0.44-0.88).


CONCLUSIONS
We raised the possibility that acupuncture may be effective in lowering the risk of AMI in stroke patients aged 50-69 in this study, which was limited by a lack of information regarding stroke severity and acupuncture points. Our results suggest that prospective randomized trials are needed to establish the efficacy of acupuncture in preventing AMI.
Department of Biomedical Engineering, National Cheng Kung University, 1 University Road, Tainan City, 701, Taiwan. alpha168a@gmail.com.
Sun-Fa
SF
Chuang
School of Chinese Medicine for Post-Baccalaureate, I-Shou University, 8 Yida Road, Kaohsiung City, 824, Taiwan. hwathai@seed.net.tw.
Chun-Chuan
CC
Shih
Department of Surgery, China Medical University Hospital, Taichung, Taiwan. b8202034@gmail.com.|Department of Surgery, University of Illinois, Chicago, USA. b8202034@gmail.com.
Chun-Chieh
CC
Yeh
School of Chinese Medicine for Post-Baccalaureate, I-Shou University, 8 Yida Road, Kaohsiung City, 824, Taiwan. imcold0404@hotmail.com.
Hsin-Long
HL
Lane
School of Chinese Medicine for Post-Baccalaureate, I-Shou University, 8 Yida Road, Kaohsiung City, 824, Taiwan. tsaicc@isu.edu.tw.|Department of Chinese Medicine, E-DA Hospital, Kaohsiung, Taiwan. tsaicc@isu.edu.tw.
Chin-Chuan
CC
Tsai
Department of Anesthesiology, Taipei Medical University Hospital, 252 Wuxing St., Taipei, 110, Taiwan. tlc@tmu.edu.tw.|Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan. tlc@tmu.edu.tw.|School of Medicine, Taipei Medical University, Taipei, Taiwan. tlc@tmu.edu.tw.
Ta-Liang
TL
Chen
School of Chinese Medicine, China Medical University, 91 Hsueh-Shih Road, Taichung, 404, Taiwan. jglin@mail.cmu.edu.tw.
Jaung-Geng
JG
Lin
Department of Biomedical Engineering, National Cheng Kung University, 1 University Road, Tainan City, 701, Taiwan. chents@mai.ncku.edu.tw.
Tainsong
T
Chen
Department of Anesthesiology, Taipei Medical University Hospital, 252 Wuxing St., Taipei, 110, Taiwan. jacky48863027@yahoo.com.tw.|Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan. jacky48863027@yahoo.com.tw.|School of Medicine, Taipei Medical University, Taipei, Taiwan. jacky48863027@yahoo.com.tw.|School of Chinese Medicine, China Medical University, 91 Hsueh-Shih Road, Taichung, 404, Taiwan. jacky48863027@yahoo.com.tw.
Chien-Chang
CC
Liao
D015670:Acupuncture Therapy / Q000706:statistics & numerical data*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control; D012189:Retrospective Studies; D012306:Risk; D020521:Stroke / Q000150:complications / Q000453:epidemiology