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The association between urinary calculi and increased risk of future cardiovascular events: A nationwide
Chien-Yi Hsu1, Yung-Tai Chen2, Po-Hsun Huang3
1Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Medicine, Taipei Veterans General Hospital Yuli Branch, Hualien, Taiwan.
Insights
Urinary calculi (kidney stones) are linked to a higher risk of heart attack and stroke. This study confirms the association in an Asian population, supporting global findings.
Area of Science:
- Cardiology
- Nephrology
- Epidemiology
Background:
- Growing evidence links urinary calculi (kidney stones) to cardiovascular disease (CVD) risk.
- Limited longitudinal studies exist on urolithiasis and CVD events.
- This study investigates the association between urinary calculi and myocardial infarction (MI) or stroke risk.
Purpose of the Study:
- To determine if urinary calculi increase the risk of developing myocardial infarction (MI) or stroke.
- To analyze the association in a large, population-based cohort in Taiwan.
Main Methods:
- Utilized data from a random sample of 1 million individuals from Taiwan's National Health Insurance Research Database.
- Included 81,546 subjects (aged 18+), with 40,773 diagnosed with urinary calculi and 40,773 propensity score-matched controls without calculi.
- Followed subjects for 10 years to identify cardiovascular events.
Main Results:
- The urinary calculi group showed higher incidence rates for MI (11.79 vs. 8.94 per 10,000 person-years) and stroke (31.41 vs. 22.45 per 10,000 person-years).
- Cox regression analysis revealed that urinary calculi independently increased the risk of future MI (HR, 1.31), stroke (HR, 1.39), and total cardiovascular events (HR, 1.38).
- All associations were statistically significant (p<0.003).
Conclusions:
- Urinary calculi are associated with an elevated risk of future cardiovascular events.
- Findings in the Asian population align with existing epidemiological evidence from Western countries.
- Highlights the importance of considering cardiovascular risk in patients with kidney stones.
Background:
Although accumulating evidence suggests urinary calculi may be associated with an increased risk of cardiovascular disease (CVD), the number of longitudinal studies linking urolithiasis to CVD events is limited. We investigated the association between urinary calculi and the risk of development of myocardial infarction (MI) and/or stroke in a nationwide, population-based cohort database in Taiwan.
Methods:
Our analyses were conducted using information from a random sample of 1 million people enrolled in the nationally representative Taiwan National Health Insurance Research Database. A total of 81,546 subjects aged 18 years or above, including 40,773 subjects diagnosed with urinary calculi during the study period and a propensity score-matched 40,773 subjects without urinary calculi were enrolled in our study.
Results:
During a 10-year follow-up period, 501 MI events and 1295 stroke events were identified. By comparison, the urinary calculi group had a higher incidence rate of MI occurrence (11.79 vs 8.94 per 10,000 person-years) and stroke (31.41 vs 22.45 per 10,000 person-years). Cox proportional hazard regression model analysis showed that development of urinary calculi was independently associated with higher risk of developing future MI (HR, 1.31; 95% CI, 1.09-1.56, p=0.003), stroke (HR, 1.39; 95% CI, 1.24-1.55, p<0.001), and total cardiovascular events (HR, 1.38; 95% CI, 1.25-1.51, p<0.001).
Conclusions:
Urinary calculi were associated with an increased risk of future cardiovascular events in the Asian population, which was consistent with the recent epidemiologic evidence in Western countries.
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