Primary Sjögren's Syndrome and the Risk of Acute Myocardial Infarction: A Nationwide Study.
BACKGROUND
Patients with autoimmune diseases have a high cardiovascular risk. However, few data are available on the risk of acute myocardial infarction (AMI) in patients diagnosed with primary Sjögren's syndrome (PSS). We conducted a large nationwide cohort study to investigate the possible association between PSS and the risk of AMI.


METHODS
Between the years 2000-2006, a total of 5205 patients with newly diagnosed PSS and no history of AMI were identified from the Registry of Catastrophic Illness, a sub-dataset of the National Health Insurance Research Database in Taiwan. The control group, which consisted of subjects without systemic autoimmune disease or previous AMI, was matched by the date of enrollment, age, gender, history of coronary artery disease, diabetes, hypertension, chronic kidney disease, and hyperlipidemia. The study endpoints were the occurrence of AMI.


RESULTS
Of the 5205 subjects with PSS and 5205 controls included in the study, 77 (35 PSS patients and 42 controls) developed AMI during the mean 3.7-year (interquartile range, 2.1-5.1 years) follow-up period. The incidence of AMI was similar in PSS patients and controls (1.91/1000 versus 2.25/1000 person-years). Multivariate analysis adjusted for baseline covariates demonstrated an insignificant association between PSS and AMI [adjusted hazard ratio, 0.86; 95% confidence interval (CI), 0.55-1.35; p = 0.506], suggesting that PSS does not increase the risk of AMI.


CONCLUSIONS
PSS is not associated with a higher risk of subsequent AMI.


BACKGROUND
Acute myocardial infarction; Atherosclerosis; Primary Sjögren's syndrome.
Division of Cardiology, Department of Medicine, Zhudong Veterans Hospital, Hsinchu; ; Division of Cardiology, Department of Medicine; ; Cardiovascular Research Center; ; Institute of Clinical Medicine;
Chia-Hung
CH
Chiang
Division of Hematology and Oncology, Department of Medicine; ; Department of Internal Medicine, National Yang-Ming University Hospital, Yilan; ; Institute of Public Health & School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Chia-Jen
CJ
Liu
Department of Family Medicine and Department of Geriatric Medicine, Chi-Mei Medical Center, Tainan;
Ping-Jen
PJ
Chen
Division of Cardiology, Department of Medicine; ; Healthcare and Management Center; ; Cardiovascular Research Center; ; Institute of Clinical Medicine;
Hsin-Bang
HB
Leu
Division of Cardiology, Department of Medicine; ; Cardiovascular Research Center;
Chien-Yi
CY
Hsu
Division of Cardiology, Department of Medicine; ; Cardiovascular Research Center; ; Institute of Clinical Medicine;
Po-Hsun
PH
Huang
Department of Family Medicine, Taipei Veterans General Hospital, Taipei;
Tzeng-Ji
TJ
Chen
Division of Cardiology, Department of Medicine; ; Department of Medical Research and Education; ; Cardiovascular Research Center; ; Institute of Clinical Medicine;
Shing-Jong
SJ
Lin
Division of Cardiology, Department of Medicine; ; Department of Medical Research and Education; ; Cardiovascular Research Center; ; Institute of Pharmacology;
Jaw-Wen
JW
Chen
Division of Cardiology, Department of Medicine; ; Healthcare and Management Center;
Wan-Leong
WL
Chan