Title : Association between parkinson disease and the risk of cardiovascular disease and all-cause mortality: A nationwide, register-based cohort study
Although epidemiologic studies have consistently reported an increase in mortality associated with Parkinson disease (PD), the relationship between cardiovascular disease (CVD) - the leading cause of death - and PD is unclear. Several studies have investigated the relationship between PD and CVD, but the results are still controversial. Therefore we conducted a nationwide population-based cohort study to assess the risk of myocardial infarction (MI), stroke, and all-cause mortality in patients with PD in Korea.
Methods: The age- and sex-matched cohorts were 25,624 patients diagnosed with PD and 128,120 individuals without PD ( ≥ 40 years; mean age, 69.0 ± 10.2 years; 42.5% men) without previous diagnosis of MI or stroke. We used the database from the Health Insurance Review and Assessment Service, which covers the entire Korean population, from 2010 to 2015. Cox proportional hazards regression models, survival analysis and log-rank test were used to evaluate the hazard ratio (HR), incidence and survival rate of MI, stroke and all-cause mortality in patients with PD.
Results: PD was significantly associated with the prospective development of MI (HR: 1.43, 95% confidence interval [CI]: 1.28–1.59), stroke (HR: 1.42, 95% CI: 1.31–1.54), and all-cause death (HR: 2.7, 95% CI: 2.60–2.81) after adjustment for multiple covariates during the 498 811.6 person-years of follow-up.
The PD group had significantly lower 6-year MI- and stroke-free rates and survival rates than the non-PD group (log-rank p < 0.0001)
Conclusion: This nationwide population-based cohort study revealed that patients with PD had higher risk of MI, stroke, and all-cause death. This finding has important implications for clinicians and supports the need for preventative measures for CVD in patients with PD.
Audience take away:
This population-based, nationwide cohort study showed an increased risk of MI, stroke, and all-cause death in patients with PD. This finding has important implications for clinicians and supports the need for preventative measures for CVD in patients with PD. Further studies are required to investigate the underlying mechanism of the association between PD and CVD and to determine how early modification of cardiovascular risk factors can reduce the risk of CVD in patients with PD.