Spinal cord injury appears to raise risk for heart disease
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Key takeaways:
- Spinal cord injury was tied to elevated risk for heart attack, heart failure and atrial fibrillation.
- The highest risk was in spinal cord injury survivors with disability.
People with spinal cord injury have elevated risk for heart attack, heart failure and atrial fibrillation compared with controls, researchers reported in the Journal of the American College of Cardiology.
The researchers used the Korean Health Insurance Service database to identify 5,083 patients with spinal cord injury (mean age, 58 years; 75% men) and to match each patient by age and sex with three participants without spinal cord injury, who formed the control group.
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The outcomes of interest were MI, HF and AF. Mean follow-up was 4.3 years.
Compared with controls, spinal cord injury survivors had higher risk for MI (adjusted HR = 2.41; 95% CI, 1.93-3), HF (aHR = 2.24; 95% CI, 1.95-2.56) and AF (aHR = 1.84; 95% CI, 1.49-2.28), Jung Eun Yoo, MD, PhD, from the department of family medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, South Korea, and colleagues wrote.
Spinal cord injury survivors with disability, defined as those registered in the National Disability Registry within 1 year from the index date, had the highest levels of risk for heart disease compared with controls (aHR for MI = 3.74; 95% CI, 2.43-5.76; aHR for HF = 3.96; 95% CI, 3.05-5.14; aHR for AF = 3.32; 95% CI, 2.18-5.05), according to the researchers.
Survivors of cervical and lumbar spinal cord injuries had elevated risk for heart disease compared with controls regardless of disability status, but survivors of thoracic spinal cord injuries were more likely to have elevated risk for heart disease if they had disability, Yoo and colleagues wrote.
“Clinicians must be aware of the importance of cardiovascular disease in the spinal cord injury population, and interventions and targeted prevention strategies addressing modifiable risk factors for cardiovascular disease should be reinforced,” the researchers wrote.
In a related editorial, Christopher R. West, PhD, from the Centre for Chronic Disease Prevention and Management and the faculty of medicine, department of cell and physiological sciences at the University of British Columbia, Vancouver, and Jacquelyn J. Cragg, PhD, from the International Collaboration on Repair Discoveries and the faculty of pharmaceutical sciences at the University of British Columbia, wrote that “the definitive population-level data provided by Yoo et al should act as ‘call-to-arms’ to researchers and clinicians to shift gears from tradition and begin studying the clinical efficacy of neuraxial therapies that could help restore autonomic balance, such as targeted neuromodulation.”
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