Incidence and risk of acute coronary syndrome in patients with acute pancreatitis: A nationwide cohort study

Pancreatology. 2017 Sep-Oct;17(5):675-680. doi: 10.1016/j.pan.2017.07.189. Epub 2017 Jul 25.

Abstract

Background: Studies on the relationship between acute pancreatitis (AP) and acute coronary syndrome (ACS) are scant. We conducted a nationwide cohort study to investigate the incidence and risk of ACS in patients with AP.

Methods: We enrolled patients newly diagnosed with AP between 2000 and 2010 from the Taiwan National Health Insurance Research Database and randomly selected a control cohort without a history of AP after frequency-matching for age, sex, and index year at a ratio of 4:1 for each patient with AP. The follow-up period was from the index date of new AP diagnosis to the diagnosis of ACS, censoring, or the end of 2011.

Results: We assessed 87 068 patients in the AP cohort and 348 272 participants in the control cohort for 508 991 and 2 301 317 person-years, respectively. The AP cohort exhibited a higher overall incidence of ACS than the control cohort (5.44 vs 3.03 per 1000 person-y). After adjustment for sex, age, and comorbidities, the AP cohort exhibited a 1.24-fold higher adjusted hazard ratio (aHR) of ACS (95% confidence interval = 1.19-1.30) than did the control cohort. When stratified by age, the patients with AP aged ≤39 years presented a 2.37-fold higher aHR of ACS than did their corresponding controls (95% CI = 1.88-2.99). Approximate one third of ACS developed within 1 month of AP occurrence.

Conclusions: This nationwide cohort study indicated that patients with AP are at an increased risk of ACS compared with those without AP.

Keywords: Acute coronary syndrome (ACS); Acute pancreatitis (AP); Cohort study.

MeSH terms

  • Acute Coronary Syndrome / complications*
  • Acute Coronary Syndrome / epidemiology*
  • Acute Disease
  • Cohort Studies
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Pancreatitis / complications*
  • Pancreatitis / epidemiology*
  • Risk Factors
  • Taiwan / epidemiology
  • Young Adult