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Suzuki Y, Kaneko H, Okada A, Fujiu K, Jo T, Takeda N, Tanaka A, Node K, Morita H, Yasunaga H, Komuro I. Benign Prostatic Hyperplasia and Incident Cardiovascular Disease. Circ J 2024; 88:408-416. [PMID: 38246651 DOI: 10.1253/circj.cj-23-0607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
BACKGROUND Data regarding the relationship between benign prostatic hyperplasia (BPH) and incident cardiovascular disease (CVD) are scarce. We aimed to clarify the association of BPH with the risk of developing CVD using a nationwide epidemiological database.Methods and Results: This retrospective observational cohort study analyzed data from the JMDC Claims Database between 2005 and 2022, including 2,370,986 men (median age 44 years). The primary endpoints were myocardial infarction (MI), angina pectoris (AP), stroke, heart failure (HF), and atrial fibrillation (AF), which were assessed separately. BPH was observed in 48,651 (2.1%) men. During a mean (±SD) follow-up of 1,359±1,020 days, 7,638 MI, 52,167 AP, 25,355 stroke, 58,183 HF, and 16,693 AF events were detected. Hazard ratios of BPH for MI, AP, stroke, HF, and AF were 1.04 (95% confidence interval [CI] 0.92-1.18), 1.31 (95% CI 1.25-1.37), 1.26 (95% CI 1.18-1.33), 1.21 (95% CI 1.16-1.27), and 1.15 (95% CI 1.07-1.24), respectively. We confirmed the robustness of our primary findings through a multitude of sensitivity analyses. In particular, a history of BPH was associated with a higher risk of developing CVD, even in participants without obesity, hypertension, diabetes, or dyslipidemia. CONCLUSIONS Our analysis of a nationwide epidemiological dataset demonstrated that BPH was associated with a greater risk of developing CVD in middle-aged men.
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Affiliation(s)
- Yuta Suzuki
- Department of Cardiovascular Medicine, The University of Tokyo
- Center for Outcomes Research and Economic Evaluation for Health, National Institute of Public Health
| | - Hidehiro Kaneko
- Department of Cardiovascular Medicine, The University of Tokyo
- Department of Advanced Cardiology, The University of Tokyo
| | - Akira Okada
- Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo
| | - Katsuhito Fujiu
- Department of Cardiovascular Medicine, The University of Tokyo
- Department of Advanced Cardiology, The University of Tokyo
| | - Taisuke Jo
- Department of Health Services Research, The University of Tokyo
| | - Norifumi Takeda
- Department of Cardiovascular Medicine, The University of Tokyo
| | | | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
| | - Hiroyuki Morita
- Department of Cardiovascular Medicine, The University of Tokyo
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo
| | - Issei Komuro
- Department of Cardiovascular Medicine, The University of Tokyo
- International University of Health and Welfare
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Kim SJ, Park HS, Kang PM, Kim BJ, Kim HS, Heo JH, Kim TS, Im SI. Effects of the beta-blocker carvedilol on arrhythmia and long-term clinical outcomes in benign prostate hypertrophy patients. Medicine (Baltimore) 2023; 102:e35008. [PMID: 37682158 PMCID: PMC10489449 DOI: 10.1097/md.0000000000035008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/08/2023] [Indexed: 09/09/2023] Open
Abstract
Benign prostatic hypertrophy (BPH) is associated with autonomic dysfunction and sympathetic nervous system mediated by the alpha receptor. However, limited data exist regarding the effects of the beta-blocker (BB) carvedilol on arrhythmia and urologic outcomes in BPH patients. Our database of patients diagnosed with BPH from 2015 to 2020 was used to obtain echocardiography and electrocardiogram data. Inclusion criteria were BPH patients taking BBs. International Prostate Symptom Score questionnaire were used to evaluate the urinary symptoms and quality of life. Among 448 patients with BPH (69.2 ± 10.9 years) taking BBs, 219 patients took carvedilol (48.9%) and 229 patients took a non-carvedilol BB (51.1%; bisoprolol, 184 patients, 80% or nebivolol, 45 patients, 20%). Difference in the baseline characteristics was not observed. During the median 36-month follow-up, a lower incidence of arrhythmic events (P = .029), total urologic events (P < .001), and less use of additive alpha-blocker was observed in the carvedilol group (P = .022). In multivariate analysis, less carvedilol use (P = .019), heart failure (P < .001), stroke (P < .001), and cardiomyopathy (P = .046) were independent risk factors for arrhythmic events. In addition, less carvedilol use (P = .009) and older age (P = .005) were independent risk factors for urologic events based on BB type at the median 36-month follow-up. The use of carvedilol was associated with less arrhythmic events in BPH patients with palpitation and decreased the incidence of urologic events in BPH compared with the use of non-carvedilol BBs in long-term follow-up.
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Affiliation(s)
- Soo Jin Kim
- Division of Cardiology, Department of Internal Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea
| | - Han Su Park
- Division of Cardiology, Department of Internal Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea
| | | | - Bong Joon Kim
- Division of Cardiology, Department of Internal Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea
| | - Hyun Su Kim
- Division of Cardiology, Department of Internal Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea
| | - Jung Ho Heo
- Division of Cardiology, Department of Internal Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea
| | - Taek Sang Kim
- Department of Urology, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea
| | - Sung Il Im
- Division of Cardiology, Department of Internal Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea
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Koçak A, Şenol C, Coşgun A, Eyyupkoca F, Yıldırım O. The relationship of benign prostatic hyperplasia's symptoms severity with the risk of developing atrial fibrillation. J Arrhythm 2022; 38:232-237. [PMID: 35387137 PMCID: PMC8977573 DOI: 10.1002/joa3.12684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/10/2022] [Accepted: 01/23/2022] [Indexed: 11/11/2022] Open
Affiliation(s)
- Ajar Koçak
- Department of Cardiology Sincan State Hospital Ankara Turkey
| | - Cem Şenol
- Department of Urology Sincan State Hospital Ankara Turkey
| | - Ayhan Coşgun
- Department of Cardiology Sincan State Hospital Ankara Turkey
| | | | - Onur Yıldırım
- Department of Cardiology Sincan State Hospital Ankara Turkey
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Fukazawa T, Ito H, Takanashi M, Shinoki R, Tabei T, Kawahara T, Keeley FX, Drake MJ, Kobayashi K. Short-term efficacy and safety of second generation bipolar transurethral vaporization of the prostate (B-TUVP) for large benign prostate enlargement: Results from a retrospective feasibility study. PLoS One 2021; 16:e0261586. [PMID: 34914804 PMCID: PMC8675650 DOI: 10.1371/journal.pone.0261586] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 12/05/2021] [Indexed: 11/19/2022] Open
Abstract
Background To investigate the efficacy and safety of a second-generation bipolar transurethral electro vaporization of the prostate (B-TUVP) with the new oval-shaped electrode for large benign prostatic enlargement (BPE) with prostate volume (PV) ≥100ml. Materials and methods 100 patients who underwent second-generation B-TUVP with the oval-shaped electrode for male lower urinary tract symptom (LUTS) or urinary retention between July 2018 and July 2020 were enrolled in this study. The patients’ characteristics and treatment outcome were retrospectively compared between patients with PV <100ml and ≥100ml. Results 17/41 (41.5%) cases of PV ≥100ml and 24/59 cases (40.7%) of PV <100ml were catheterised due to urinary retention. The duration of post-operative catheter placement and hospital-stay of PV ≥100ml (3.1±1.3 and 5.6±2.3 days) were not different from PV <100ml (2.7±1.2 and 5.0±2.4 days). In uncatheterised patients (N = 59), post-void residual urine volume (PVR) significantly decreased after surgery in both groups, however, maximum uroflow rate (Qmax) significantly increased after surgery only in PV <100ml but not in PV ≥100ml. Voiding symptoms and patients’ QoL derived from International Prostate Symptom Score (IPSS), IPSS-QoL (IPSS Quality of Life Index) and BPH Impact Index (BII) scores, significantly improved after B-TUVP in both groups. Catheter free status after final B-TUVP among patients with preoperative urinary retention was achieved in 18/24 (75.0%) and 14/17 (82.1%) cases in patient with <100ml and ≥100ml, respectively. There was no significant difference in post-operative Hb after B-TUVP, which was 97.0±5.4% of baseline for PV <100ml and 96.9±6.1% for PV ≥100ml and no TUR syndrome was observed. Conclusions This is the first study investigating short-term efficacy and safety of second-generation B-TUVP with the oval-shaped electrode on large BPE. B-TUVP appears to be effective and safe for treating moderate-to-severe lower urinary tract symptoms and urinary retention in patients with large BPE.
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Affiliation(s)
- Takeshi Fukazawa
- Department of urology, Yokosuka Kyosai Hospital, Yokosuka, Japan
| | - Hiroki Ito
- Department of urology, Yokosuka Kyosai Hospital, Yokosuka, Japan
- Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
- * E-mail:
| | - Masato Takanashi
- Department of urology, Yokosuka Kyosai Hospital, Yokosuka, Japan
| | - Risa Shinoki
- Department of urology, Yokosuka Kyosai Hospital, Yokosuka, Japan
- Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Tadashi Tabei
- Department of urology, Yokosuka Kyosai Hospital, Yokosuka, Japan
| | - Takashi Kawahara
- Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Francis X. Keeley
- Bristol Medical School and Bristol Urological Institute, Southmead Hospital, Bristol, United Kingdom
| | - Marcus J. Drake
- Bristol Medical School and Bristol Urological Institute, Southmead Hospital, Bristol, United Kingdom
| | - Kazuki Kobayashi
- Department of urology, Yokosuka Kyosai Hospital, Yokosuka, Japan
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Wang X, Su Y, Yang C, Hu Y, Dong JY. Benign prostatic hyperplasia and cardiovascular risk: a prospective study among Chinese men. World J Urol 2021; 40:177-183. [PMID: 34426873 DOI: 10.1007/s00345-021-03817-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 08/17/2021] [Indexed: 01/13/2023] Open
Abstract
PURPOSE To examine the prospective association of BPH with subsequent risk of CVD, including heart disease and stroke. METHODS We used data from China Health and Retirement Longitudinal Study of 5242 Chinese men aged 45 years or older. During a follow-up of 7 years, we identified 613 cases of non-fatal CVD, including 417 heart diseases and 254 strokes. Cox proportional hazards models yielded hazard ratios (HRs) relating BPH to CVD, heart disease, and stroke incidence. RESULTS Overall, 8.1% of men reported a history of BPH diagnosed by physicians at baseline. As compared with men without a history of BPH, those reporting a history of BPH had an increased risk of developing CVD (multivariable-adjusted HR = 1.43 [1.12, 1.83], heart disease (1.35 [1.00, 1.83]), and stroke (1.50 [1.03, 2.19]). The subgroup analysis by age at baseline (< 60 vs. ≥ 60 years) showed that the associations appeared to be evident among men < 60 years, particularly for CVD (1.82 [1.24, 2.69]) and heart disease (1.72 [1.06, 2.79]). However, interaction tests suggested the associations were not significantly modified by age (P for interaction > 0.10 for all outcomes). CONCLUSION In Chinese men, BPH was associated with higher risks of CVD, heart disease and stroke, particularly among men aged < 60 years.
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Affiliation(s)
- Xiaowen Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, 100191, China.,Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, 5650871, Japan
| | - Yang Su
- Department of Urology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450002, China
| | - Chao Yang
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, 100034, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Jia-Yi Dong
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, 5650871, Japan.
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Tanaka Y, Matsuyama S, Tada H, Hayashi K, Takamura M, Kawashiri MA, Passman R, Greenland P. Association of Lower Urinary Tract Symptoms Based on the International Prostate Symptom Score and Cardiovascular Disease. Circ J 2021; 85:2092-2099. [PMID: 34219077 DOI: 10.1253/circj.cj-21-0278] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Because it is unclear whether lower urinary tract symptoms (LUTS) are associated with cardiovascular disease (CVD) in the Japanese population, we explored the association in general Japanese men aged 55-75 years.Methods and Results:The cross-sectional study included male participants who had both national health checkup data and the International Prostate Symptom Score (IPSS) in the same calendar year between 2009 and 2017. LUTS severity was evaluated by IPSS. A robust Poisson regression model was used to assess the association between LUTS severity and the composite CVD outcome [coronary artery disease (CAD), stroke, or atrial fibrillation (AF)] and each component of the composite outcome. Prevalence ratio (PR) was adjusted for conventional cardiovascular risk factors. Of 16,781 male participants (mean age, 67±5 years), mild LUTS were observed in 9,243 (55.1%); moderate, 6,445 (38.4%); and severe, 1,093 (6.5%). Compared with the mild LUTS group, moderate LUTS [PR 1.18, 95% confidence interval (CI) 1.10-1.25, P<0.001] and severe LUTS (PR 1.38, 95% CI 1.24-1.53, P<0.001) were significantly associated with a higher prevalence of CVD. LUTS severity was associated with higher prevalence of CAD and stroke, but not AF. CONCLUSIONS The severity of LUTS was associated with a higher prevalence of CVD, especially CAD and stroke, independent of conventional CVD risk factors.
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Affiliation(s)
- Yoshihiro Tanaka
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine.,Center for Arrhythmia Research, Northwestern University Feinberg School of Medicine.,Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences
| | | | - Hayato Tada
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences
| | - Kenshi Hayashi
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences
| | - Masayuki Takamura
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences
| | - Masa-Aki Kawashiri
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences
| | - Rod Passman
- Center for Arrhythmia Research, Northwestern University Feinberg School of Medicine.,Division of Cardiology, Northwestern University Feinberg School of Medicine
| | - Philip Greenland
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine
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Gu A, Agarwal A, Fassihi SC, Bovonratwet P, Campbell JC, Sculco PK. Does Symptomatic Benign Prostatic Hyperplasia Increase the Risk of Periprosthetic Joint Infection After Primary Total Joint Arthroplasty? J Arthroplasty 2021; 36:897-904. [PMID: 33032874 DOI: 10.1016/j.arth.2020.09.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 09/09/2020] [Accepted: 09/14/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Periprosthetic joint infection (PJI) is among the leading causes of failure in total joint arthroplasty. A recently proposed risk factor for PJI is symptomatic benign prostatic hyperplasia (sBPH). This study aims to determine if sBPH is associated with PJI following primary total hip arthroplasty (THA) and total knee arthroplasty (TKA). METHODS Using the Mariner all-payer claims database, 1745 patients with sBPH undergoing primary THA were propensity-matched with 3490 controls, and 3053 patients with sBPH undergoing primary TKA were propensity-matched with 6106 controls. Additionally, the same 1745 patients with sBPH undergoing THA were compared to 317,360 prematched controls, and the same 3053 patients with sBPH undergoing TKA were compared to 557,730 prematched controls. Univariate analysis was conducted using chi-squared or ANOVA where appropriate. RESULTS At two years postoperatively, patients with sBPH were not at significantly increased risk for PJI following primary THA (1.54% vs 1.43%; P = .745) and TKA (1.99% vs 2.14%; P = .642) relative to postmatch controls. Compared to matched controls, THA patients with sBPH had an increased 90-day incidence of anemia (P < .001), blood transfusion (P < .001), and urinary tract infection (UTI; P < .001). Total knee arthroplasty patients with sBPH had an increased 90-day incidence of anemia (P < .001), blood transfusion (P < .001), cellulitis (P = .023), renal failure (P = .030), heart failure (P = .029), and UTI (P < .001) relative to matched controls. CONCLUSION In primary THA and TKA, sBPH does not appear to be an independent risk factor for PJI within two years postoperatively. However, clinicians should be cognizant of the significantly increased risk for postoperative UTI in this patient population.
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Affiliation(s)
- Alex Gu
- Department of Orthopaedic Surgery, George Washington University Hospital, Washington, DC; Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, NY
| | - Amil Agarwal
- Department of Orthopaedic Surgery, George Washington University Hospital, Washington, DC
| | - Safa C Fassihi
- Department of Orthopaedic Surgery, George Washington University Hospital, Washington, DC
| | | | - Joshua C Campbell
- Department of Orthopaedic Surgery, George Washington University Hospital, Washington, DC
| | - Peter K Sculco
- Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, NY
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Semczuk-Kaczmarek K, Płatek AE, Szymański FM. Co-treatment of lower urinary tract symptoms and cardiovascular disease - where do we stand? Cent European J Urol 2020; 73:42-45. [PMID: 32395322 PMCID: PMC7203768 DOI: 10.5173/ceju.2020.0029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 02/17/2020] [Accepted: 02/17/2020] [Indexed: 01/21/2023] Open
Abstract
Introduction The relationship between cardiovascular disease (CVD) and lower urinary tract symptoms (LUTS) is well established. A healthy lifestyle with a good quality diet and regular physical activity is important for reducing the severity of LUTS. Material and methods A literature search was performed on the subject of association between LUTS and cardiovascular risk. Results The recent data indicates that therapy for cardiovascular risk reduction might also reduce the severity of LUTS (e.g. statins reduce the risk of benign prostatic hyperplasia [BPH] and slow down the progression of LUTS in patients with hyperlipidaemia). Hypertensive patients treated with angiotensin II receptor blockers have a lower severity of LUTS. This paper shortly discusses the relationship between the occurrence of LUTS and CVD and the potential clinical implications regarding the management of the patients. Conclusions Patients with lower urinary tract symptoms require a holistic approach and cooperation of a urologist and cardiologist to diagnose concomitant cardiovascular diseases as early as possible and implement appropriate treatment. Antihypertensive, antithrombotic, hypolipemic therapies and healthy lifestyles reduce not only cardiovascular mortality, but also might reduce the severity of LUTS.
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Affiliation(s)
| | - Anna E Płatek
- Department of General and Experimental Pathology with Centre for Preclinical Research and Technology (CEPT), Medical University of Warsaw, Warsaw, Poland
| | - Filip M Szymański
- 1 Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
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Hu WS, Lin CL. Increased risk of atrial fibrillation in patients with benign prostatic hyperplasia: A population-based cohort study. Clin Cardiol 2018; 41:1374-1378. [PMID: 30144121 DOI: 10.1002/clc.23063] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 08/22/2018] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE The objective was to compare the rate of onset of atrial fibrillation (AF) in patients with benign prostatic hyperplasia (BPH) as compared with controls. METHODS We performed a retrospective study on national health registry comparing the incidence of AF between a cohort of 15 670 BPH patients and a propensity-matched cohort of 15 670 control patients. Univariable and multivariable Cox proportional hazards models were performed to estimate the hazard ratios (HR) and 95% confidence intervals (CI) of incident AF associated with BPH. A subgroup analysis was performed to evaluate the risk of AF among BPH patients whether they received a BPH surgery or not as compared with those without BPH. RESULTS We found a 4.77 incidence rate per 1000 person-years in the BPH group, compared to 3.76 in the control group. After controlling for the confounders, a significant association between BPH and risk of incident AF was shown with an adjusted HR = 1.19, 95% CI = 1.11-1.28) and this association was attenuated once surgical intervention for BPH has been applied (adjusted HR = 0.86, 95% CI = 0.76-0.97). CONCLUSIONS This study supported the notion that BPH is associated with greater AF occurrence.
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Affiliation(s)
- Wei-Syun Hu
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
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