Risk of acute coronary syndrome after parathyroidectomy in patients with end-stage renal disease: A population-based cohort study in Taiwan.

AIM: Patients with end-stage renal disease (ESRD) who received parathyroidectomy (PTX) had persistently reduced levels of parathyroid hormone. This study investigated the risk of acute coronary syndrome (ACS) in patients with ESRD who underwent PTX using a nationwide health insurance claims database.

METHODS: Of all ESRD patients, we selected 1047 individuals who had undergone PTX between 2000 and 2008 as the PTX group and 4188 patients who did not undergo PTX (non-PTX group) matched by propensity score. Multivariable Cox proportional hazards regression analysis was conducted for assessing the excess ACS risk for the PTX group compared to the non-PTX group.

RESULTS: The mean follow-up periods were 4.63 and 4.04 years for the PTX and non-PTX groups, respectively. A significant reduction in the risk of ACS (adjusted hazard ratio = 0.74, 95% confidence interval = 0.57-0.96) was observed for the ESRD patients after PTX.

CONCLUSIONS: Parathyroidectomy is associated with reduced risk of ACS in patients with ESRD.