Risk of Parkinson Disease and Secondary Parkinsonism in Myocardial Infarction Survivors.
Risk of Parkinson Disease and Secondary Parkinsonism in Myocardial Infarction Survivors.
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DOI：
10.1161/jaha.121.022768
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发表时间：
2022-03
影响因子：
5.4
通讯作者：
Sorensen, Henrik Toft
中科院分区：
文献类型：
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作者：
Sundboll, Jens;Szepligeti, Szimonetta Komjathine;Szentkuti, Peter;Adelborg, Kasper;Horvath-Puho, Erzsebet;Pedersen, Lars;Henderson, Victor W.;Sorensen, Henrik Toft
除了原发性神经退行性过程外，血管疾病，如中风，也可导致帕金森病。然而，一些心血管风险因素，如吸烟和胆固醇水平升高，与帕金森病的风险降低有关。我们研究了心肌梗死（MI） 1年幸存者帕金森病和继发性帕金森病的风险。我们在1995年至2016年期间使用丹麦医疗登记处进行了一项基于全国人口的匹配队列研究。我们确定了所有首次诊断为心肌梗死的患者，并抽样了性别、年龄和日历年匹配的普通人群比较队列，没有心肌梗死。使用Cox回归分析计算帕金森病和继发性帕金森病的调整风险比（aHRs），控制匹配因素，并调整相关合并症和社会经济因素。我们确定了18994例心肌梗死患者和90970例匹配的对照队列成员（中位年龄71岁，62%为男性）。经过21年的随访，在心肌梗死队列中，帕金森病的累积发病率为0.9%，继发性帕金森病的累积发病率为0.1%。与普通人群队列相比，心肌梗死与帕金森病（aHR, 0.80; 95% CI, 0.73-0.87）和继发性帕金森病（aHR, 0.72; 95% CI, 0.54-0.94）的风险降低相关。心肌梗死与帕金森病风险降低20%和继发性帕金森病风险降低28%相关。降低的风险可能反映了心血管危险因素与帕金森病之间的反比关系。
In addition to primary neurodegenerative processes, vascular disorders, such as stroke, can lead to parkinsonism. However, some cardiovascular risk factors, such as smoking and elevated cholesterol levels, are associated with reduced risk of Parkinson disease. We examined the risk of Parkinson disease and secondary parkinsonism in 1‐year survivors of myocardial infarction (MI). We conducted a nationwide population‐based matched cohort study using Danish medical registries from 1995 to 2016. We identified all patients with a first‐time MI diagnosis and sampled a sex‐, age‐, and calendar year–matched general population comparison cohort without MI. Cox regression analysis was used to compute adjusted hazard ratios (aHRs) for Parkinson disease and secondary parkinsonism, controlled for matching factors and adjusted for relevant comorbidities and socioeconomic factors. We identified 181 994 patients with MI and 909 970 matched comparison cohort members (median age, 71 years; 62% men). After 21 years of follow‐up, the cumulative incidence was 0.9% for Parkinson disease and 0.1% for secondary parkinsonism in the MI cohort. Compared with the general population cohort, MI was associated with a decreased risk of Parkinson disease (aHR, 0.80; 95% CI, 0.73–0.87) and secondary parkinsonism (aHR, 0.72; 95% CI, 0.54–0.94). MI was associated with a 20% decreased risk of Parkinson disease and 28% decreased risk of secondary parkinsonism. Reduced risk may reflect an inverse relationship between cardiovascular risk factors and Parkinson disease.