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Association between heat stroke and ischemic heart disease: A national longitudinal cohort study in Taiwan

  • Min-Feng Tseng
    Affiliations
    Department of Internal Medicine, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan

    Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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  • Chu-Lin Chou
    Affiliations
    Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

    Department of Medical Research, Ping-Tung Christian Hospital, Ping-Tung, Taiwan
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  • Chi-Hsiang Chung
    Affiliations
    School of Public Health, National Defense Medical Center, Taipei, Taiwan

    Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
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  • Author Footnotes
    1 Equal contribution.
    Wu-Chien Chien
    Correspondence
    Corresponding author.
    Footnotes
    1 Equal contribution.
    Affiliations
    School of Public Health, National Defense Medical Center, Taipei, Taiwan
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  • Ying-Kai Chen
    Affiliations
    Department of Internal Medicine, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan
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  • Hsiu-Chien Yang
    Affiliations
    Department of Internal Medicine, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan
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  • Author Footnotes
    1 Equal contribution.
    Pauling Chu
    Correspondence
    Corresponding author at: Division of Nephrology, Tri-Service General Hospital, 325 Section 2, Cheng-Kung Road, Neihu District 114, Taipei, Taiwan.
    Footnotes
    1 Equal contribution.
    Affiliations
    Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

    Center for the Prevention and Treatment of Heat Stroke, Tri-Service General Hospital, Taipei, Taiwan
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  • Author Footnotes
    1 Equal contribution.
Published:October 05, 2018DOI:https://doi.org/10.1016/j.ejim.2018.09.019

      Highlights

      • An association between heat stroke episodes and IHD events was seen.
      • The onset of IHD in patients with heat stroke was earlier than without heat stroke.
      • Being vigilant about the atherosclerotic complications in patients with heat stroke.

      Abstract

      The purpose of this study is to determine the relationship between heat stroke and ischemic heart disease (IHD), in a nationwide population using a longitudinal approach. We retrospectively examined the data from the National Health Insurance Research Database (NHIRD) in Taiwan, for patients examined between 2000 and 2013. In total, 628 patients with a heat stroke episode were enrolled and matched with 1256 patients without any history of a heat stroke episode by propensity score matching at a ratio of 1:2. The mean follow-up years of the heat stroke group was 11.89 years and the mean follow up of the control group was 11.51 years. An association between heat stroke episodes and IHD (log-rank p < .001) was found in a univariate cox regression analysis. After multivariate adjustment, age, comorbidities (hypertension, diabetes, stroke), and lower insurance premiums were associated with IHD events in patients who had a heat stroke. IHD was independently associated with heat stroke following cox multivariate regression analysis and patients with a heat stroke episode had a higher incidence of IHD events compared to those without any heat stroke episode (2598.41/105 person-years vs. 1286.14/105 person-years, adjusted hazard ratio 3.527, 95% CI: 2.078–4.032, p < .001). The onset of IHD in patients who suffered a heat stroke was earlier than in those without a heat stroke episode (2.08 ± 3.45 vs. 3.61 ± 3.25 years, p < .001). In conclusion, clinicians should be aware about evaluating the IHD risk following a heat stroke episode in a patient.

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