Increased risk of endotracheal intubation and heart failure following acute myocardial infarction in patients with urolithiasis: a nationwide population-based study

Shun-Ku Lin; Jui-Ming Liu; Ying-Hsu Chang; Yuan-Tien Ting; See-Tong Pang; Ren-Jun Hsu; Po-Hung Lin

doi:10.2147/TCRM.S123702

Increased risk of endotracheal intubation and heart failure following acute myocardial infarction in patients with urolithiasis: a nationwide population-based study

Ther Clin Risk Manag. 2017 Feb 23:13:245-253. doi: 10.2147/TCRM.S123702. eCollection 2017.

Authors

Shun-Ku Lin¹, Jui-Ming Liu², Ying-Hsu Chang³, Yuan-Tien Ting⁴, See-Tong Pang³, Ren-Jun Hsu⁵, Po-Hung Lin⁶

Affiliations

¹ Institute of Traditional Medicine, School of Medicine, National Yang-Ming University; Department of Chinese Medicine, Taipei City Hospital, Ren-Ai Branch, Taipei.
² Division of Urology, Department of Surgery, Taoyuan General Hospital, Ministry of Health and Welfare.
³ Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan.
⁴ Division of Urology, Department of Surgery, Chang Bing Show Chwan Memorial Hospital, Changhua.
⁵ Biobank Management Center of the Tri-Service General Hospital; Department of Pathology and Graduate Institute of Pathology and Parasitology, the Tri-Service General Hospital; Graduate Institute of Life Sciences, National Defense Medical Center, Taipei.
⁶ Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan; Graduate Institute of Clinical Medical Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China.

Abstract

Background: Urolithiasis is a common urinary tract disease worldwide. It has been connected to systemic diseases, including hypertension, diabetes mellitus, metabolic syndrome, and cardiovascular disease. In the current study, we aimed to evaluate the relationship between urolithiasis and the complications of acute myocardial infarction (AMI).

Materials and methods: Data were obtained from the Longitudinal Health Insurance Database 2005 of the National Health Insurance Research Database. All AMI cases, both those who were hospitalized and those who were treated in the emergency department, were identified using the International Classification of Diseases, ninth revision, Clinical Modification (ICD-9-CM) code.

Results: A total of 37,052 patients with urinary calculi and 148,209 control subjects were enrolled in this study. The average follow-up period was 9.51 years. The risk of AMI was higher among patients with urolithiasis (adjusted hazard ratio [aHR] 1.07, 95% confidence interval [95% CI] 1.03-1.13). We detected a significant association between urolithiasis and intubation (aHR 1.53, 95% CI 1.36-1.73), intensive care unit treatment (aHR 1.22, 95% CI 1.13-1.32), heart failure (aHR 1.59, 95% CI 1.42-1.78), shock (aHR 1.53, 95% CI 1.32-1.77), and arrhythmias (aHR 1.18, 95% CI 1.06-1.33). Furthermore, certain medical treatments for urolithiasis were found to be related to myocardial infarction (MI). Nonsteroidal anti-inflammatory drugs (NSAIDs) were significantly associated with a high risk of AMI. In contrast, allopurinol, thiazide diuretic, potassium-sparing diuretics, and α-blockers have negative association with AMI.

Conclusion: Urolithiasis had a significantly increased risk of endotracheal intubation and heart failure following AMI. In addition, urolithiasis was also associated with a high risk of intensive care unit treatment, shock, and arrhythmias after AMI. Medical treatments for urolithiasis may decrease the risk of MI, except the use of NSAIDs.

Keywords: National Health Insurance Research Database; acute myocardial infarction; endotracheal intubation; heart failure; renal calculi; urolithiasis.