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

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

Research output: Contribution to journalArticle

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Abstract

Background: 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. Methods: Taiwan'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. Results: Stroke 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). Conclusions: We 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.

Original languageEnglish
Article number318
JournalBMC Complementary and Alternative Medicine
Volume15
Issue number1
DOIs
Publication statusPublished - Sep 9 2015

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Acupuncture Therapy
Cohort Studies
Retrospective Studies
Stroke
Myocardial Infarction
Confidence Intervals
Acupuncture
Acupuncture Points
Propensity Score
Incidence
National Health Programs
Taiwan
Proportional Hazards Models

Keywords

  • Acupuncture
  • Acute myocardial infarction (AMI)
  • Stroke

ASJC Scopus subject areas

  • Complementary and alternative medicine

Cite this

Decreased risk of acute myocardial infarction in stroke patients receiving acupuncture treatment : A nationwide matched retrospective cohort study. / Chuang, Sun Fa; Shih, Chun Chuan; Yeh, Chun Chieh; Lane, Hsin Long; Tsai, Chin Chuan; Chen, Ta-Liang; Lin, Jaung Geng; Chen, Tainsong; Liao, Chien-Chang.

In: BMC Complementary and Alternative Medicine, Vol. 15, No. 1, 318, 09.09.2015.

Research output: Contribution to journalArticle

Chuang, Sun Fa ; Shih, Chun Chuan ; Yeh, Chun Chieh ; Lane, Hsin Long ; Tsai, Chin Chuan ; Chen, Ta-Liang ; Lin, Jaung Geng ; Chen, Tainsong ; Liao, Chien-Chang. / Decreased risk of acute myocardial infarction in stroke patients receiving acupuncture treatment : A nationwide matched retrospective cohort study. In: BMC Complementary and Alternative Medicine. 2015 ; Vol. 15, No. 1.
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AU - Shih, Chun Chuan

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AU - Lane, Hsin Long

AU - Tsai, Chin Chuan

AU - Chen, Ta-Liang

AU - Lin, Jaung Geng

AU - Chen, Tainsong

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AB - Background: 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. Methods: Taiwan'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. Results: Stroke 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). Conclusions: We 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.

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