The Association of Acute Myocardial Infarction with Pyogenic Spondylitis in Korea: A Nationwide Longitudinal Cohort Study

Objective: The goal of this nationally matched longitudinal study was to investigate the relationship between acute myocardial infarction (AMI) and pyogenic spondylitis (PS) in Korea. Methods: We collected patient data from the National Health Insurance Service Health Screening cohort from January 1, 2004 to December 31, 2015. PS was classified using the In-ternational Classification of Diseases codes M46.2 (osteomyelitis), M46.8 (inflammatory spon-dylopathy), M49.2 (enterobacterial spondylitis), and M49.3 (enterobacterial spondylitis) (spon-dylopathy in other infectious and parasitic diseases). The PS group had a total of 628 patients. The control group included 3,140 people. Utilizing the Kaplan-Meier technique, the groups’ AMI rates were estimated. A Cox proportional-hazards regression analysis was used to com-pute the hazard ratio for AMI. Results: After controlling for age and sex, the hazard ratio for AMI in the PS group was 2.241 (95% confidence interval [CI], 1.112–4.516). The adjusted hazard ratio in the PS group was 2.138 after controlling for demographics and concomitant medical conditions (95% CI, 1.056– 4.318). In a subgroup analysis, the AMI percentages were substantially greater in the PS group in women over 65, those with diabetes, and in non-hypertension and non-dyslipidemia sub-groups. Conclusion: This nationwide longitudinal study found that PS patients had an elevated risk of AMI.