Risk and Mortality of Cardiovascular Diseases in Patients with Dupuytren Disease: A Nationwide Population-Based Cohort Study

초록

Background: Dupuytren disease (DD) is a type of fibroproliferative disease that involves the palmar aspect of the hand. Although many benign fibroproliferative diseases have been shown to increase the risk of cardiovascular disease, the relationship between DD and myocardial infarction (MI) or stroke has not been fully elucidated. Methods: A total of 35,909 patients with DD and a control cohort with 1,077,270 age- and sex-matched participants from the Korean National Health Insurance database were included. The incidences of MI, stroke, and survival after cardiovascular events, were compared between participants with DD and the control cohort. Results: Compared with the control cohort, the incidence rate ratios for cardiovascular diseases in DD were as follows: 1.51 (95% CI, 1.44 to 1.58) for MI; 2.01 (95% CI, 1.94 to 2.09) for ischemic stroke (IS); and 1.49 (95% CI, 1.36 to 1.63) for hemorrhagic stroke . After adjusting for other cardiovascular disease risk factors, DD was associated with an increased risk of IS. Based on the age-, sex-, and body mass index-stratified analyses, an increased risk of MI was identified in the younger age group (<50 years) and thin subjects (body mass index < 18.5 kg/m(2)). Adjusted hazard ratios for mortality in subjects with DD who developed cardiovascular diseases were 0.51 (95% CI, 0.43 to 0.60), 0.56 (95% CI, 0.50 to 0.62), and 1.08 (95% CI, 0.86 to 1.36), respectively. Conclusions: DD is associated with an increased risk of IS, independent of cardiovascular risk factors. DD is also associated with an increased risk of MI in individuals younger than 50 years. DD did not significantly aggravate mortality secondary to cardiovascular events.CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, II.