Increased risk of cardiovascular diseases in patients with chronic rhinosinusitis: a longitudinal follow-up study using a national health screening cohort

Jeon, Yung Jin; Lee, T H; Joo, Younghoo; Cho, H J; Kim, S W; Park, B; Choi, Hyo Geun

doi:10.4193/rhin21-211

Cited by 8 publications

(8 citation statements)

References 52 publications

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“…Although different methodological approaches were followed, all of them concluded that CRS can be considered a relevant risk factor for stroke. In greater detail, a recent longitudinal follow-up study proved that CRS patients had a significantly higher prevalence of stroke compared to controls, even after adjusting for traditional cardiovascular risk factors, which also is in agreement with the results of Lee et al [ 3 , 12 ]. Notably, the hazard ratio (HR) of stroke was significantly higher in patients without nasal polyps than in those with nasal polyps [ 12 ].…”

Section: Reviewsupporting

confidence: 89%

“…In greater detail, a recent longitudinal follow-up study proved that CRS patients had a significantly higher prevalence of stroke compared to controls, even after adjusting for traditional cardiovascular risk factors, which also is in agreement with the results of Lee et al [ 3 , 12 ]. Notably, the hazard ratio (HR) of stroke was significantly higher in patients without nasal polyps than in those with nasal polyps [ 12 ]. Wu et al also compared the risk of stroke between CRS patients and controls and found that patients had a 1.39-fold increased risk during a three-year follow-up period [ 1 ].…”

Section: Reviewsupporting

confidence: 89%

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Rhinosinusitis and Stroke: A Systematic Review

Παπαδοπούλου¹,

Marinou²

2023

Cureus

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Rhinosinusitis is one of the most common inflammatory diseases. It has been recognized that intracranial vessels are involved and there might be an association with stroke occurrence. The aim of this study was to evaluate the association between rhinosinusitis and cardiovascular diseases, especially stroke, through a literature review. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. We performed on PubMed a literature search from February 2000 to February 2022, using the search terms ‘rhinosinusitis’ OR ‘chronic rhinosinusitis’ AND ‘stroke’ OR ‘ischemic stroke’. Fourteen studies were eligible and included in the analysis. Overall, the studies encompassed a total of 1,006,338 patients included in this review. All studies concluded that there is a statistically significant correlation between clinical or radiological sinus inflammation and the risk of stroke, which is independent of traditional stroke risk factors. In conclusion, rhinosinusitis is associated with an increased incidence of stroke.

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Section: Reviewsupporting

confidence: 89%

Section: Reviewsupporting

confidence: 89%

Rhinosinusitis and Stroke: A Systematic Review

Παπαδοπούλου¹,

Marinou²

2023

Cureus

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“…Modern literature describes the relationship between the incidence of rhinosinusitis and that of cardiovascular pathology [42]. Cardiovascular comorbid pathology (hypertensive disease and ischemic heart disease), which we have identified in a significant number of cases, can lead to hemodynamic, trophic and alterative changes in the sinonasal mucosa.…”

Section: Discussionmentioning

confidence: 91%

Rhinosinusitis in Patients in Post-Covid-19 Period: Etiology, Clinical and Morphological Characteristics

Myroshnychenko

Kalashnyk-Vakulenko

Kapustnyk³

et al. 2022

Wiad Lek

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The aim is to identify the etiology, clinical and morphological features of rhinosinusitis in patients in post-COVID-19 period. Materials and methods: In the present study, it was carried out the analysis of 11 cases of rhinosinusitis, which developed after COVID-19 infection. The diagnosis of rhi¬nosinusitis was established on the basis of anamnesis, clinical and laboratory examination, specialized instrumental examination (rhinoendoscopy, X-ray, magnetic resonance imaging, spiral and 3D computed tomography). All patients underwent endoscopic sanitation of the nasal cavity, expansion of the maxillary anastomosis, maxillary sinusotomy, sanitation of the maxillary sinuses and removal of pathologically altered tissues. Microbiological examination of the swab from the nasal cavity was carried out in all patients. Histological and morphometric research methods were used during the morphological study of surgical material. The nonparametric Mann-Whitney U test was used to compare the means in the groups. Results: The conducted comprehensive study made it possible to identify chronic atrophic rhinosinusitis at the stage of exacerbation caused by associations of bacteria and fungi in patients in post-COVID-19 period. Among bacteria, the authors most often noted Staphylococcus aureus, Staphylococcus epidermidis, Klebsiella pneumonia, Streptococcus pneumonia and Enterococcus faecalis. Among fungi, there were Aspergillus, Candida, Mucor and Coccidioides. Fungal infection was characterized by invasion into the mucous membrane of the nose and paranasal sinuses. In patients in post-COVID-19 period the invasive bacterial-fungal chronic atrophic rhinosinusitis at the stage of exacerbation was predominantly bilateral, characterized by the involvement of several or all paranasal sinuses in the process. Patients with such pathology complained of periodic fever, headaches and malaise; nasal congestion and constant difficulty in nasal breathing; yellowish-greenish-reddish discharge from the nasal cavity, sometimes with a fetid odor; discomfort and pain in the area of paranasal sinuses; immobility of the eyeball, hyposmia or anosmia; reduction or complete loss of vision. Frequent risk factors for the development of invasive bacterial-fungal chronic atrophic rhinosinusitis at the stage of exacerbation in patients in post-COVID-19 period were the information about moderate or severe course of this infection in anamnesis; comorbidities (predominantly diabetes mellitus, hypertensive disease and ischemic heart disease). Conclusions: The study conducted by the authors made it possible to identify the etiological, clinical and morphological features, as well as risk factors of rhinosinusitis in patients in post-COVID-19 period. This information will contribute to a better understanding of such pathology by the doctors and improve the diagnostic and treatment process.

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“…Lee et al observed an augmented susceptibility to hemorrhagic stroke (HR = 2.43, 95% CI: 2.10–2.80) and ischemic stroke (HR = 1.76, 95% CI: 1.61–1.92) within the Korean population affected by CRS ( 7 ). In a distinct investigation, Jeon et al discerned a notably heightened prevalence of stroke among individuals with CRS in Korea, as denoted by an adjusted odds ratio of 1.27 (95% CI = 1.15–1.39) ( 32 ). Additionally, Kim et al established a correlation between chronic rhinosinusitis and an elevated incidence of stroke (HR = 1.16, 95% CI: 1.08–1.24) in the Korean population ( 33 ).…”

Section: Discussionmentioning

confidence: 99%

Genetically predicted chronic rhinosinusitis and the risk of stroke: a two-sample Mendelian randomization study

Hu,

Wang,

Zhou

2024

Front. Neurol.

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ObjectiveThe causal association between chronic rhinosinusitis (CRS) and stroke remains uncertain due to the susceptibility of observational studies to confounding and the possibility of reverse causality. This study aims to examine the potential causal relationship between CRS and the risk of stroke, encompassing various subtypes.MethodsIn this research, we utilized genome-wide association study (GWAS) data for CRS from FinnGen. We identified significant single-nucleotide polymorphisms (SNPs) associated with CRS and used them as instrumental variables (IVs). GWAS data for any ischemic stroke (AIS), ischemic stroke (IS), large-artery atherosclerotic stroke (LAS), small-vessel strokes (SVS), cardioembolic strokes (CES), intracerebral hemorrhage (ICH), lobar ICH, and non-lobar ICH came from multi-ancestry GWAS datasets. We conducted two-sample Mendelian randomization (MR) analyses using inverse variance weighting (IVW), weighted median, and MR-Egger regression methods to investigate potential causal relationships between CRS and stroke. Both heterogeneity and pleiotropy were evaluated by sensitivity analyses.ResultThe IVW analysis revealed no significant associations between CRS and AIS (OR = 0.99, 95% CI [0.93–1.05], p = 0.73), IS (OR = 0.97, 95% CI [0.81–1.17], p = 0.09), SVS (OR = 0.96, 95% CI [0.82–1.12], p = 0.58), LAS (OR = 0.91, 95% CI [0.77–1.08], p = 0.09), CES (OR = 0.97, 95% CI [0.81–1.17], p = 0.79), ICH (OR = 1.28, 95% CI [0.74–2.22], p = 0.28), lobar ICH (OR = 1.22, 95% CI [0.60–2.50], p = 0.28), and non-lobar ICH (OR = 1.25, 95% CI [0.65–2.40], p = 0.79). Sensitivity analysis found no evidence of horizontal pleiotropy.ConclusionAccording to genetic evidence, this Mendelian randomization (MR) study does not indicate a causal relationship between CRS and stroke in European populations. However, further studies are necessary to comprehensively evaluate the potential association between CRS and stroke.

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Increased risk of cardiovascular diseases in patients with chronic rhinosinusitis: a longitudinal follow-up study using a national health screening cohort

Cited by 8 publications

References 52 publications

Rhinosinusitis and Stroke: A Systematic Review

Rhinosinusitis and Stroke: A Systematic Review

Rhinosinusitis in Patients in Post-Covid-19 Period: Etiology, Clinical and Morphological Characteristics

Genetically predicted chronic rhinosinusitis and the risk of stroke: a two-sample Mendelian randomization study

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