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Association of Traumatic Injury and Incident Myocardial Infarction and Stroke: A Prospective Population-Based Cohort
Xin Liu1, Aitian Wang2, Tao Liu1
1Institute of Disaster and Emergency Medicine, Tianjin University, 300072 Tianjin, China.
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.
