Idiopathic Sudden Sensorineural Hearing Loss Is Not a Sentinel Event for Acute Myocardial Infarction

Crowson, Matthew G.; Mulder, Hillary; Cyr, Derek D.; Langman, Alan W.; Lee, Walter T.; Parham, Kourosh; Pynnonen, Melissa A.; Schulz, Kristine; Shin, Jennifer J.; Witsell, David L.; Vambutas, Andrea

doi:10.1097/mao.0000000000001868

Cited by 6 publications

(16 citation statements)

References 19 publications

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“…All studies used administrative datasets. Three studies used the Korean National Health Insurance Service National Sample Cohort (KNH‐NSC) database, 19‐21 three used the Taiwanese National Health Insurance Research Database (NHIRD), 12‐14 and one used the American Truven Health MarketScan Research Database 22 . All studies matched their controls for age and gender.…”

Section: Resultsmentioning

confidence: 99%

“…In addition, accumulating evidence indicates that cardiovascular risk factors, like smoking and elevated homocysteine levels, may contribute to ISSNHL 15‐18 . Recently, several national database studies have been published investigating if patients with ISSNHL have an increased risk of developing stroke and myocardial infarction (MI) 19‐22 …”

Section: Introductionmentioning

confidence: 99%

“…[15][16][17][18] Recently, several national database studies have been published investigating if patients with ISSNHL have an increased risk of developing stroke and myocardial infarction (MI). [19][20][21][22] However, consistent evidence supporting the various pathophysiologic hypotheses, prognostic associations, and even treatment recommendations for ISSNHL is scarce. 1,23 This is probably due to a multifactorial pathogenesis causing the acute hearing loss, leading to conflicting findings in the majority of small scale studies.…”

Section: Introductionmentioning

confidence: 99%

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Risk of Stroke and Myocardial Infarction After Sudden Sensorineural Hearing Loss: A Meta‐Analysis

et al. 2020

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Objectives/Hypothesis: The pathophysiology of idiopathic sudden sensorineural hearing loss (ISSNHL) is still unknown, but labyrinthine artery infarction has been proposed. The objective of this study was to perform a systematic review and conduct a meta-analysis assessing the risk of developing stroke and myocardial infarction after presentation with ISSNHL.Methods: A systematic literature review was conducted using Pubmed, Embase, Web of Science, and Cochrane Libraries. All studies investigating an association between ISSNHL and stroke and/or myocardial infarction (MI) were included. Adhering to the MOOSE guideline, two independent reviewers extracted data, assessed risk of bias, and evaluated the relevance and quality of evidence.Results: Three observational studies evaluating the risk of stroke in ISSNHL were included (n = 6,521 patients). All individual study results indicated an increased relative risk of stroke after ISSNHL (unadjusted relative risk range 1.21-1.63). Pooled adjusted hazard ratios revealed a 1.42-fold increased risk of stroke after ISSNHL (hazard ratio [HR] 1.42; 95% confidence interval [CI] 1.15-1.75, I 2 = 55%). Subgroup analysis of one study demonstrated that the increased risk is only present in adults aged above 50 years (HR 1.23; 95% CI 1.07-1.42). Five observational studies evaluating the risk of MI in patients with ISSNHL were included (n = 61,499 patients). Pooled analyses demonstrated that ISSNHL was not associated with MI (HR 1.08, 95% CI 0.87-1.34).Conclusion: ISSNHL may be an independent risk factor for the subsequent development of stroke especially in a subgroup of elderly patients. More studies are needed to confirm this association and to assess whether such patients would benefit from cardiovascular risk assessment and management to prevent future strokes.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Risk of Stroke and Myocardial Infarction After Sudden Sensorineural Hearing Loss: A Meta‐Analysis

et al. 2020

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“…It was also suggested that patients with ISSNHL had a higher risk of developing future stroke, 12,13 although ISSNHL was not associated with future acute myocardial infarction. 13,14 Quaranta et al reported signs of endothelial dysfunction in ISSNHL and Fisch described the blood pressure dysregulation of the stria vascularis (a process related to age and CVRFs) as a consequence of cochlear atherosclerosis, in which the tunica adventitia loses fibroblasts and becomes thicker, which in turn leads to plasmatic viscosity and platelet aggregation. [15][16][17] As a consequence, vascular pathology is supposed an important etiological factor of ISSNHL.…”

Section: Introductionmentioning

confidence: 99%

“…However, past reviews reported evidence until 2014 and did not report information from some CVRFs (high levels of triglycerides [TG], high‐density lipoprotein cholesterol [HDL‐c], and metabolic syndrome [MetS]) 7 issues that are addressed in the present work. It was also suggested that patients with ISSNHL had a higher risk of developing future stroke, 12,13 although ISSNHL was not associated with future acute myocardial infarction 13,14 …”

Section: Introductionmentioning

confidence: 99%

Cardiovascular Risk and Sudden Sensorineural Hearing Loss: A Systematic Review and Meta‐Analysis

et al. 2022

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Objectives/Hypothesis: It was previously suggested that patients with idiopathic sudden sensorineural hearing loss (ISSNHL) have a higher risk of cardiovascular disease. The aim of this study is to determine if ISSNHL patients have an increased cardiovascular risk by means of a systematic review and meta-analysis.Methods: A systematic literature review was performed using PubMed, Embase, Cochrane Libraries and Web of Science. Studies with a clear definition of ISSNHL, investigating an association between traditional vascular risk factors and ISSNHL were included. Adhering to Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, two reviewers extracted the data, assessed the risk of bias and performed the analysis of the collected evidence.Results: Nineteen case-control studies and two cohort studies were included (102,292 patients). Individual studies argued for higher prevalence of hypercholesterolemia, diabetes mellitus (DM) and higher blood pressure (HBP) in ISSNHL patients with a range of odds ratios (ORs) from 1.03 to 19. Pooled analysis of adjusted ORs revealed a significantly increased risk of ISSNHL for patients with hypertriglyceridemia (OR 1.54; 95% confidence interval [CI] 1.18-2.02) and high levels of total cholesterol (TC) (OR 2.09; 95% CI 1.52-2.87 after sensitivity analysis), but not for HBP, DM, or high levels of low-and highdensity lipoproteins.Conclusion: An association between higher vascular risk profile and ISSNHL seems apparent in high levels of triglycerides (TG) and TC, but more studies are needed to confirm this hypothesis due to the high levels of data heterogeneity in the literature.

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Association between Sudden Sensorineural Hearing Loss and the Risk of Cardio Cerebrovascular Disease

Park,

Jang,

Hurh

et al. 2023

The Laryngoscope

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ObjectivesThis study investigated the association between sudden sensorineural hearing loss (SSNHL) and the risk of cardio‐cerebrovascular disease (CCVD) among older adults in South Korea.MethodsData from 38,426 patients in the Korean National Health Insurance Service‐Senior Cohort from 2002 to 2019 were collected. The risk of CCVD includes both stroke and acute myocardial infarction. Propensity score matching (1:1) was used to identify pairs of individuals with and without SSNHL (n = 19,213 for cases and controls). Cox proportional hazards regression models were used to analyze the associations between variables.ResultsPatients with SSNHL had a higher risk of CCVD (hazard ratio [HR] = 1.17, 95% confidence interval [CI] = 1.11–1.24) compared to those without. The risk of CCVD was higher among those who experienced a stroke than those who did not (HR = 1.17 95% CI = 1.10–1.25). Compared to their matched controls, patients with SSNHL were 1.69 times (HR = 1.69 CI = 1.46–1.94) more likely to have CCVD during the first 12 months of the follow‐up period.ConclusionOlder patients with SSNHL are at an increased risk of CCVD. Hence, a more attentive approach featuring aggressive monitoring of patients with SSNHL is required to lessen their risk of CCVD.Level of EvidenceLevel 3 Laryngoscope, 2023

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Idiopathic Sudden Sensorineural Hearing Loss Is Not a Sentinel Event for Acute Myocardial Infarction

Cited by 6 publications

References 19 publications

Risk of Stroke and Myocardial Infarction After Sudden Sensorineural Hearing Loss: A Meta‐Analysis

Risk of Stroke and Myocardial Infarction After Sudden Sensorineural Hearing Loss: A Meta‐Analysis

Cardiovascular Risk and Sudden Sensorineural Hearing Loss: A Systematic Review and Meta‐Analysis

Association between Sudden Sensorineural Hearing Loss and the Risk of Cardio Cerebrovascular Disease

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