Decreased risk of acute myocardial infarction in stroke patients receiving acupuncture treatment: a nationwide matched retrospective cohort study.

Sun-Fa Chuang,Tainsong Chen,Chun-Chuan Shih,Chun-Chieh Yeh,Ta-Liang Chen,Jaung-Geng Lin,Chin-Chuan Tsai,Hsin-Long Lane,Chien-Chang Liao

doi:10.1186/s12906-015-0828-8

Abstract

BackgroundWhether acupuncture protects stroke patients from acute myocardial infarction (AMI) has not been studied previously. The purpose of this study was to investigate the risk of AMI among stroke patients receiving acupuncture treatment.MethodsTaiwan’s National Health Insurance Research Database was used to conduct a retrospective cohort study of 23475 stroke patients aged 40–79 years receiving acupuncture treatment and 46950 propensity score-matched stroke patients not receiving acupuncture treatment who served as controls from 2000 to 2004. Both stroke cohorts were followed until the end of 2009 and were adjusted for immortal time to measure the incidence and adjusted hazard ratios (HRs) with 95 % confidence intervals (CIs) for new-onset AMI in multivariate Cox proportional hazard models.ResultsStroke patients who received acupuncture treatment (9.2 per 1000 person-years) exhibited a lower incidence of AMI compared with those who did not receive acupuncture treatment (10.8 per 1000 person-years), with an HR of 0.86 (95 % CI, 0.80–0.93) after adjusting for age, sex, low income, coexisting medical conditions and medications. The relationship between acupuncture treatment and AMI risk was investigated in female stroke patients (HR, 0.85; 95 % CI, 0.76–0.95), male stroke patients (HR, 0.87; 95 % CI, 0.80–0.95), patients from 50 to 59 years of age (HR, 0.75; 95 % CI, 0.63–0.90), patients from 60 to 69 years of age (HR, 0.85; 95 % CI, 0.75–0.95), patients suffering from ischemic stroke (HR, 0.87; 95 % CI, 0.79–0.95), and patients suffering from hemorrhagic stroke (HR, 0.62; 95 % CI, 0.44–0.88).ConclusionsWe raised the possibility that acupuncture may be effective in lowering the risk of AMI in stroke patients aged 50–69 in this study, which was limited by a lack of information regarding stroke severity and acupuncture points. Our results suggest that prospective randomized trials are needed to establish the efficacy of acupuncture in preventing AMI.

Highlights

Whether acupuncture protects stroke patients from acute myocardial infarction (AMI) has not been studied previously
The relationship between the risk of new-onset AMI and acupuncture treatment exhibited no significant difference with respect to gender
The age-stratified results demonstrated that the relationship between AMI risk and acupuncture treatment was significant in stroke patients aged 50–59 years (HR, 0.75; 95 % confidence interval (CI), 0.63–0.90) and 60–69 years (HR, 0.85; 95 % CI, 0.75–0.95)

Summary

Introduction

Whether acupuncture protects stroke patients from acute myocardial infarction (AMI) has not been studied previously. The purpose of this study was to investigate the risk of AMI among stroke patients receiving acupuncture treatment. Stroke is the second leading cause of death and a major cause of acquired disability worldwide [1]. As a major cause of long-term disability, stroke greatly influences quality of life and imposes a tremendous burden on affected individuals and their families [1]. The high risk of acute myocardial infarction (AMI) and sudden cardiac death after stroke has been documented previously [3, 4]. Stroke and AMI share similar atherosclerotic pathophysiologic mechanisms and risk factors, which results in a complex relationship [5]

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