Risk of adverse cardiovascular events following spinal cord injury in patients with osteoporosis: Real-world evidence
Introduction: Spinal cord injury (SCI) is associated with increased cardiovascular risks, and cardiovascular disease (CVD) remains a leading cause of death for individuals with SCI. Osteoporosis, a condition associated with SCI, has been linked to CVD. However, the cardiovascular risk profile of ind...
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Elsevier
2025-03-01
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| Series: | American Journal of Preventive Cardiology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S266666772500011X |
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| author | Shih-Kai Kao Yu-Ting Yu Ming-Hsien Tsai |
| author_facet | Shih-Kai Kao Yu-Ting Yu Ming-Hsien Tsai |
| author_sort | Shih-Kai Kao |
| collection | DOAJ |
| description | Introduction: Spinal cord injury (SCI) is associated with increased cardiovascular risks, and cardiovascular disease (CVD) remains a leading cause of death for individuals with SCI. Osteoporosis, a condition associated with SCI, has been linked to CVD. However, the cardiovascular risk profile of individuals with SCI with osteoporosis remains unclear. Methods: We conducted a retrospective cohort study by using data from the TriNetX Research Network. We included adults with osteoporosis with or without a diagnosis of SCI between 2015 and 2020: case (SCI group, N = 7,308) and control (non-SCI group, N = 843,235) cohorts. Propensity score matching was performed to balance baseline characteristics between the cohorts (N = 7,296 in each group). A Cox regression model was employed to estimate the hazard ratio (HR) for the primary outcomes: the development of acute myocardial infarction (AMI), atrial fibrillation (AF), or heart failure (HF). Results: Individuals with SCI with osteoporosis have a significantly higher risk of cardiovascular events (HR: 1.15, 95 % confidence interval [CI]: 1.08–1.22)—including AMI (HR: 1.17 95 % CI: 1.02–1.33), AF (HR: 1.14, 95 % CI: 1.04–1.24), and HF (HR: 1.14, 95 % CI: 1.05–1.24)—than do those without SCI. Furthermore, mortality risk is higher in individuals with SCI, particularly those with pathological fracture. Subgroup analyses based on sex and age supported these findings. Conclusion: The complex interplay between SCI, osteoporosis, and cardiovascular health underscores the requirement for comprehensive management strategies for individuals with SCI who also have osteoporosis. |
| format | Article |
| id | doaj-art-250eac36284640348e6ad314b6e53238 |
| institution | Kabale University |
| issn | 2666-6677 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Preventive Cardiology |
| spelling | doaj-art-250eac36284640348e6ad314b6e532382025-02-07T04:48:24ZengElsevierAmerican Journal of Preventive Cardiology2666-66772025-03-0121100938Risk of adverse cardiovascular events following spinal cord injury in patients with osteoporosis: Real-world evidenceShih-Kai Kao0Yu-Ting Yu1Ming-Hsien Tsai2Department of General Medicine, Shin Kong Wu Huo-Shih Memorial Hospital, Taipei, Taiwan; Department of Psychiatry, Taipei Veterans General Hospital, Taipei, TaiwanDepartment of General Medicine, Shin Kong Wu Huo-Shih Memorial Hospital, Taipei, Taiwan; Division of Family Medicine, Department of Community Medicine, Landseed International Hospital, Taoyuan, TaiwanDivision of Nephrology, Department of Internal Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; Department of Medicine, Fu-Jen Catholic University School of Medicine, Taipei, Taiwan; Corresponding author at: Division of Nephrology, Department of internal medicine, Shin-Kong Wu Ho-Su Memorial Hospital, 95, Wen-Chang Rd, Shih-Lin, Taipei 111, Taiwan.Introduction: Spinal cord injury (SCI) is associated with increased cardiovascular risks, and cardiovascular disease (CVD) remains a leading cause of death for individuals with SCI. Osteoporosis, a condition associated with SCI, has been linked to CVD. However, the cardiovascular risk profile of individuals with SCI with osteoporosis remains unclear. Methods: We conducted a retrospective cohort study by using data from the TriNetX Research Network. We included adults with osteoporosis with or without a diagnosis of SCI between 2015 and 2020: case (SCI group, N = 7,308) and control (non-SCI group, N = 843,235) cohorts. Propensity score matching was performed to balance baseline characteristics between the cohorts (N = 7,296 in each group). A Cox regression model was employed to estimate the hazard ratio (HR) for the primary outcomes: the development of acute myocardial infarction (AMI), atrial fibrillation (AF), or heart failure (HF). Results: Individuals with SCI with osteoporosis have a significantly higher risk of cardiovascular events (HR: 1.15, 95 % confidence interval [CI]: 1.08–1.22)—including AMI (HR: 1.17 95 % CI: 1.02–1.33), AF (HR: 1.14, 95 % CI: 1.04–1.24), and HF (HR: 1.14, 95 % CI: 1.05–1.24)—than do those without SCI. Furthermore, mortality risk is higher in individuals with SCI, particularly those with pathological fracture. Subgroup analyses based on sex and age supported these findings. Conclusion: The complex interplay between SCI, osteoporosis, and cardiovascular health underscores the requirement for comprehensive management strategies for individuals with SCI who also have osteoporosis.http://www.sciencedirect.com/science/article/pii/S266666772500011XSpinal cord injuryOsteoporosisCardiovascular diseaseMortalityReal word data |
| spellingShingle | Shih-Kai Kao Yu-Ting Yu Ming-Hsien Tsai Risk of adverse cardiovascular events following spinal cord injury in patients with osteoporosis: Real-world evidence American Journal of Preventive Cardiology Spinal cord injury Osteoporosis Cardiovascular disease Mortality Real word data |
| title | Risk of adverse cardiovascular events following spinal cord injury in patients with osteoporosis: Real-world evidence |
| title_full | Risk of adverse cardiovascular events following spinal cord injury in patients with osteoporosis: Real-world evidence |
| title_fullStr | Risk of adverse cardiovascular events following spinal cord injury in patients with osteoporosis: Real-world evidence |
| title_full_unstemmed | Risk of adverse cardiovascular events following spinal cord injury in patients with osteoporosis: Real-world evidence |
| title_short | Risk of adverse cardiovascular events following spinal cord injury in patients with osteoporosis: Real-world evidence |
| title_sort | risk of adverse cardiovascular events following spinal cord injury in patients with osteoporosis real world evidence |
| topic | Spinal cord injury Osteoporosis Cardiovascular disease Mortality Real word data |
| url | http://www.sciencedirect.com/science/article/pii/S266666772500011X |
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