Increased Risk of Coronary Artery Disease in People with Diagnosis of Neuromuscular Disorders: A Nationwide
Yi-Chuan Chang1,2, Ing-Shiow Lay2,3, Cheng-Hao Tu1
1Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, Taichung 404328, Taiwan.
Insights
Carpal tunnel syndrome (CTS) may uniquely predispose individuals to coronary artery disease (CAD). Unlike other neuromuscular disorders, median nerve injury showed a significant association with CAD in this study.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Epidemiology
Background:
- Existing literature suggests a link between carpal tunnel syndrome (CTS) and coronary artery disease (CAD).
- Limited research has compared the association of CAD with CTS against other neuromuscular disorders (NMDs).
Purpose of the Study:
- To investigate the association between CTS, stenosing tenosynovitis (ST), ulnar NMDs, and CAD.
- To determine if CTS is a unique risk factor for CAD compared to other NMDs.
Main Methods:
- A case-control study utilizing Taiwan's National Health Insurance Research Database (2000-2011).
- Identified 64,025 CAD patients (case group) and matched controls without CAD.
- Logistic regression analysis was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs).
Main Results:
- Multivariate analysis revealed a significantly higher likelihood of prior CTS diagnosis in the CAD group.
- No significant association was found between ST or ulnar NMDs and CAD.
- Median nerve injury (CTS) uniquely predicted CAD risk after adjusting for covariates.
Conclusions:
- Carpal tunnel syndrome, indicative of median nerve injury, may be a distinct predisposing factor for coronary artery disease.
- Stenosing tenosynovitis and ulnar-sided NMDs were not found to be significantly associated with CAD in this cohort.
Abstract:
The existing literature has explored carpal tunnel syndrome (CTS) and determined that it could be a risk for coronary artery disease (CAD), but there has been little research comparing the relevance of CAD with other neuromuscular disorders (NMDs) to CTS. This case-control study explored the association between CTS, stenosing tenosynovitis (ST), and ulnar side NMDs and CAD. The study utilized data from Taiwan's National Health Insurance Research Database, focusing on health insurance claims. Between January 2000 and December 2011, we employed the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnostic codes to identify 64,025 CAD patients as the case group. The control group consisted of an equal number of individuals without CAD, matched for age, sex, and index year of CAD. Logistic regression analysis was employed to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for each variable. Multivariate analysis, after adjusting for sociodemographic factors and comorbidities, revealed a significantly higher likelihood of a previous diagnosis of CTS in the CAD group compared to the comparison control group. However, neither ST nor the ulnar side NMDs had any statistical significance. These results indicated that median nerve injury, rather than other NMDs, may uniquely serve as a predisposing factor of CAD.
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