IMR Press / RCM / Volume 24 / Issue 5 / DOI: 10.31083/j.rcm2405136
Open Access Original Research
Association of Traumatic Injury and Incident Myocardial Infarction and Stroke: A Prospective Population-Based Cohort Study
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1 Institute of Disaster and Emergency Medicine, Tianjin University, 300072 Tianjin, China
2 Department of Intensive Medicine, Kailuan General Hospital, 063001 Tangshan, Hebei, China
3 Department of Cardiology, Kailuan General Hospital, 063001 Tangshan, Hebei, China
*Correspondence: houshike@tju.edu.cn (Shike Hou); caochunxia@tju.edu.cn (Chunxia Cao)
These authors contributed equally.
Rev. Cardiovasc. Med. 2023, 24(5), 136; https://doi.org/10.31083/j.rcm2405136
Submitted: 23 November 2022 | Revised: 25 December 2022 | Accepted: 4 January 2023 | Published: 28 April 2023
(This article belongs to the Section Lifestyle and Risk Factors)
Copyright: © 2023 The Author(s). Published by IMR Press.

This is an open access article under the CC BY 4.0 license.

Abstract

Background: Several studies have linked traumatic injury and cardiovascular disease. However, few studies have investigated the associations between traumatic injury and cardiovascular disease subtypes. We aimed to prospectively examine the association between traumatic injury and the risk of incident myocardial infarction (MI) and stroke. Methods: This study was based on a prospective cohort study that included 13,973 patients who had been hospitalized for traumatic injuries from 1980 to 2020. We randomly selected 4 uninjured participants from the cohort study for each patient as controls matched by age (±3 years) and sex. All participants were free of MI and stroke at enrollment. Cox regression was used to examine the association between traumatic injury and incident MI and stroke. Results: During a median follow-up period of 13.5 years, 1032 cases of MI and 4068 cases of stroke were recorded. After multivariable adjustment, relative to controls, patients with severe injury had the highest hazard ratio (HR) for MI (HR = 1.93; 95% CI: 1.26–2.96) and stroke (HR = 1.60; 95% CI: 1.25–2.05). The HRs of MI and stroke were 0.97 (0.81–1.17) and 1.11 (1.02–1.21) for patients with mild injury and 1.28 (0.97–1.69) and 1.22 (1.06 to 1.41) for patients with moderate injury. Additionally, patients with older age at injury and chest injury had a higher HR for MI and stroke (p-interaction < 0.05). Conclusions: Traumatic injury appears to be associated with an increased risk of incident MI and stroke. Therefore, early screening and prevention of MI and stroke following a traumatic injury are needed.

Keywords
traumatic injury
myocardial infarction
stroke
cohort study
Funding
2021YFC260050401/National Key R&D Program of China
2019YFC160630401/National Key R&D Program of China
Figures
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