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Association between acupuncture treatment exposure and mortality in patients with heart failure: a nationwide cohort
Hyungsun Jun1, Hanbit Jin2, Haerim Kim3
1Department of Diagnostics, College of Korean Medicine, Wonkwang University, Iksan, Republic of Korea.
Insights
Acupuncture treatment for heart failure (HF) patients in Korea was associated with reduced mortality from circulatory diseases and all causes. This accessible, insurance-covered therapy showed a dose-response relationship, indicating more treatment led to better outcomes.
Area of Science:
- Cardiology
- Integrative Medicine
- Public Health
Background:
- Heart failure (HF) necessitates ongoing management to mitigate mortality.
- Acupuncture is a financially accessible treatment option in Korea due to national health insurance coverage.
- Investigating complementary therapies like acupuncture is crucial for improving HF patient outcomes.
Purpose of the Study:
- To examine the association between acupuncture exposure and mortality in patients diagnosed with heart failure.
- To assess the impact of acupuncture on circulatory disease-related and all-cause mortality in HF patients.
- To explore a potential dose-response relationship between acupuncture treatment frequency and mortality reduction.
Main Methods:
- Utilized Korean National Health Insurance Service claims data for a retrospective cohort study.
- Included adult patients (≥20 years) with newly diagnosed heart failure.
- Employed propensity score matching to create balanced groups of acupuncture-exposed and non-exposed patients (1:1 ratio) and tracked mortality over five years.
Main Results:
- The acupuncture treatment group (n=4,315) demonstrated significantly lower adjusted hazard ratios for circulatory disease-related mortality (aHR=0.79) and all-cause mortality (aHR=0.73) compared to the non-exposed group.
- A statistically significant dose-response relationship was identified, where increased acupuncture exposure correlated with decreased mortality.
- The findings suggest a protective effect of acupuncture in heart failure management.
Conclusions:
- Acupuncture initiated within one year of heart failure diagnosis is linked to reduced circulatory and all-cause mortality.
- The study highlights acupuncture as a potentially beneficial intervention for heart failure patients.
- Further prospective research with rigorous methodologies is recommended to confirm these findings.
Introduction:
Patients with heart failure (HF) require continuous management, creating a need for alternative treatments to reduce mortality. In Korea, acupuncture treatment is covered by national health insurance, offering accessible care without financial burden. Hence, this study utilized claims data from the Korean National Health Insurance Service to examine the association between acupuncture exposure and mortality in patients with HF.
Methods:
Adults aged 20 years or older with newly diagnosed HF were included. Patients who received two or more acupuncture sessions within one year of diagnosis comprised the acupuncture treatment-exposed group (AT group), while those who received none were classified as the non-exposed group (non-AT group). Propensity score matching was used to generate a balanced 1:1 matched cohort. From one year after diagnosis, the study tracked circulatory and all-cause mortality over a five-year period, performing survival and dose-response analyses.
Results:
Each group included 4,315 patients, and the AT group showed significantly lower adjusted hazard ratios (aHRs) for circulatory disease-related mortality (0.79; 95% CI: 0.67-0.94) and all-cause mortality (0.73; 95% CI: 0.66-0.81). A clear dose-response relationship was observed, with greater exposure to acupuncture associated with lower aHRs.
Discussion:
Acupuncture within one year of HF diagnosis correlated with lower mortality from circulatory diseases and all causes. Future studies should adopt prospective and methodologically rigorous designs to validate the findings of this study.
