Article Text

Download PDFPDF
Original article
Increased risk of coronary heart disease in patients with chronic osteomyelitis: a population-based study in a cohort of 23 million
  1. Lien-Cheng Hsiao1,
  2. Chih-Hsin Muo2,
  3. Yu-Ching Chen3,
  4. Che-Yi Chou4,5,
  5. Chun-Hung Tseng6,7,
  6. Kuan-Cheng Chang1,4
  1. 1Division of Cardiology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
  2. 2Institute of Environmental Health, College of Public Health, China Medical University, Taichung, Taiwan
  3. 3Department of Biomedical Informatics, Asia University, Taichung, Taiwan
  4. 4Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
  5. 5Department of Nephrology, China Medical University Hospital, Taichung, Taiwan
  6. 6Department of Neurology, China Medical University Hospital, Taichung, Taiwan
  7. 7School of Medicine, China Medical University, Taichung, Taiwan
  1. Correspondence to Dr Kuan-Cheng Chang, Division of Cardiology, Department of Medicine, China Medical University Hospital 2, Yuh-Der Road, Taichung 40447, Taiwan; kuancheng.chang{at}gmail.comDr Chun-Hung Tseng, Department of Neurology, School of Medicine, China Medical University 91, Hsueh-Shih Road, Taichung, 40402, Taiwan;


Objectives Chronic inflammatory disease may trigger vascular atherosclerosis. This study aimed to determine whether chronic osteomyelitis (COM) is linked to an increased risk of coronary heart disease (CHD).

Methods A national insurance claim dataset of more than 23 million enrolees was used to identify 15 054 patients with newly diagnosed COM and 60 216 randomly selected age-matched and gender-matched controls between 2001 and 2009 for comparing the risk and incidence of CHD. The study period was from the entry date to the first date of the following events: the diagnosis of CHD, death, withdrawal from the Taiwan National Health Insurance programme or the end of 2010. The analysis of the CHD risk was performed using Cox proportional hazards regression model.

Results During a follow-up period of 67 927 person-years, the overall incidence rate of CHD in COM cohort was 1.95 times higher than non-COM cohort (16.66 vs 8.52 per 1000 person-years). After controlling age, gender and four comorbidities (hypertension, diabetes, hyperlipidaemia and stroke), the risk remained significantly higher in the COM cohort than the control group (adjusted HR=1.65, 95% CI 1.54 to 1.78, p<0.001). In age-stratified analysis, the younger population had a stronger association between COM and CHD risk than the elderly (from HR=3.42, 95% CI 1.60 to 7.32 in age <35 to HR  1.39, 95% CI 1.15 to 1.68 in age ≥80).

Conclusions This study demonstrates that COM is an independent risk factor for CHD, particularly in the younger population. Further studies are necessary to explore the underlying mechanisms linking COM and CHD.

  • Coronary Artery Disease

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.