The association between urinary calculi and increased risk of future cardiovascular events: A nationwide population-based study.
BACKGROUND
Although accumulating evidence suggests urinary calculi may be associated with an increased risk of cardiovascular disease (CVD), the number of longitudinal studies linking urolithiasis to CVD events is limited. We investigated the association between urinary calculi and the risk of development of myocardial infarction (MI) and/or stroke in a nationwide, population-based cohort database in Taiwan.


METHODS
Our analyses were conducted using information from a random sample of 1 million people enrolled in the nationally representative Taiwan National Health Insurance Research Database. A total of 81,546 subjects aged 18 years or above, including 40,773 subjects diagnosed with urinary calculi during the study period and a propensity score-matched 40,773 subjects without urinary calculi were enrolled in our study.


RESULTS
During a 10-year follow-up period, 501 MI events and 1295 stroke events were identified. By comparison, the urinary calculi group had a higher incidence rate of MI occurrence (11.79 vs 8.94 per 10,000 person-years) and stroke (31.41 vs 22.45 per 10,000 person-years). Cox proportional hazard regression model analysis showed that development of urinary calculi was independently associated with higher risk of developing future MI (HR, 1.31; 95% CI, 1.09-1.56, p=0.003), stroke (HR, 1.39; 95% CI, 1.24-1.55, p<0.001), and total cardiovascular events (HR, 1.38; 95% CI, 1.25-1.51, p<0.001).


CONCLUSIONS
Urinary calculi were associated with an increased risk of future cardiovascular events in the Asian population, which was consistent with the recent epidemiologic evidence in Western countries.
Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Medicine, Taipei Veterans General Hospital Yuli Branch, Hualien, Taiwan.
Chien-Yi
CY
Hsu
Department of Medicine, Taipei City Hospital, Heping Fuyou Branch, Taipei, Taiwan.
Yung-Tai
YT
Chen
Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan.
Po-Hsun
PH
Huang
Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan; Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan.
Hsin-Bang
HB
Leu
Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan; Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Yu-Wen
YW
Su
Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
Chia-Hung
CH
Chiang
Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan; Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Clinical Research, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan.
Jaw-Wen
JW
Chen
Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan.
Tzeng-Ji
TJ
Chen
Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan; Taipei Medical University, Taipei, Taiwan.
Shing-Jong
SJ
Lin
Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan; Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan; Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan. Electronic address: wlchan@vghtpe.gov.tw.
Wan-Leong
WL
Chan
D016022:Case-Control Studies; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology*; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology; D014545:Urinary Calculi / Q000453:epidemiology*
Cardiovascular disease prevention; Myocardial infarction; Stroke; Urinary calculi