title: An association between autosomal-dominant polycystic kidney disease and the risk of acute myocardial infarction in Asian population - results of a nationwide study.
abstract: Cardiovascular complications are the leading causes of death in patients with autosomal-dominant polycystic kidney disease (ADPKD) in the Western countries. However, theprevalence and risk of acute myocardial infarction (AMI) in patients with ADPKD remain unknown, especially in Asian population. We utilized the data from Taiwan National Health Insurance Research Database (NHIRD) to perform a population-based cohort study (1997-2008). A total of 2062 patients with ADPKD were selected from one million of general population after excluding those patients with age less than 18 years old, receiving renal replacement therapy, and concomitant diagnoses of AMI. Additionally, we set up those patients without ADPKD as comparison group by matching study cohort with age, gender, income and urbanization with 1:10 ratio (n=20620). The results showed that although the prevalence of AMI in ADPKD patients in Taiwan was lower than those in the United States (2.91% v.s. 6%, p=0.0567), the Taiwanese ADPKD group had significantly higher prevalence of AMI as compared with the non-ADPKD group (2.91% v.s. 0.97%, p<0.0001). In addition, Kaplan-Meier analysis demonstrated that cumulative incidence of AMI was significantly higher in ADPKD than in the non-ADPKD group (all p<0.001). After adjusting for age, gender and comorbidities by multivariate and sensitivity analysis, ADPKD patients had 2.43-fold greater risk for developing AMI as compared with non-ADPKD patients (95% CI 1.8 to 3.29, p<0.0001). In conclusion, Taiwanese patients with ADPKD have lower prevalence of AMI as compared to Americans, whereas ADPKD per se remains independently predictive of AMI in Asian population.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Pei-Hsun
authors.initials: PH
authors.lastname: Sung
authors.affiliation: Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Hsin-Ju
authors.initials: HJ
authors.lastname: Chiang
authors.affiliation: Department for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan.|Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan.|Center of Excellence for Chang Gung Research Datalink, Chang Gung Memorial Hospital, Chiayi, Taiwan.
authors.forename: Yao-Hsu
authors.initials: YH
authors.lastname: Yang
authors.affiliation: Center of Excellence for Chang Gung Research Datalink, Chang Gung Memorial Hospital, Chiayi, Taiwan.
authors.forename: Chi-Jen
authors.initials: CJ
authors.lastname: Chen
authors.affiliation: Department of Computer Science and Engineering, National Sun Yat-Sen University, Kaohsiung, Taiwan.|Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: John Y
authors.initials: JY
authors.lastname: Chiang
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.|Institute for Translational Research in Biomedicine, Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.|Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan.|Department of Nursing, Asia University, Taichung, Taiwan.
authors.forename: Hon-Kan
authors.initials: HK
authors.lastname: Yip
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001208:Asia / Q000453:epidemiology; D015415:Biomarkers; D016022:Case-Control Studies; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000209:etiology; D016891:Polycystic Kidney, Autosomal Dominant / Q000150:complications*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan; D055815:Young Adult
chemical_list: D015415:Biomarkers
keywords: Asian; Taiwanese; acute myocardial infarction; autosomal-dominant polycystic kidney disease; population-based cohort study