Long-term risk of acute coronary syndrome in splenectomized patients due to splenic injury

We aimed to assess the magnitude and duration of risk of acute coronary syndrome (ACS) associated with splenectomy for splenic injury. We identified 5139 splenectomized patients (the splenectomy cohort) to compare with 2 other cohorts for assessing the magnitude and risk of ACS: the first cohort comprising subjects without splenic injury and without splenectomy (control cohort), and the second cohort comprising nonsplenectomized patients with splenic injury (nonsplenectomy cohort; n=6391). For each splenic injury patient (n=11530), 4 control comparisons were frequency-matched by the year of index date, age, and sex (n=46120). The adjusted risk of ACS was significantly higher in the splenectomy group than in the control group (2.08 vs 1.68 per 1000 person-years; adjusted hazard ratio [HR], 1.30; 95% confidence interval [CI], 1.01-1.68). The sex-specific data showed that the adjusted HR for the splenectomy group, compared with the control group, was 1.29 in men (95% CI, 0.97-1.73) and 1.36 in women (95% CI, 0.79-2.33). The age-specific analyses failed to demonstrate a significantly higher adjusted HR of ACS in the splenectomized patients in any age subgroup, compared with their counterparts in the control group. Furthermore, no difference in the risk of ACS was detected between the splenectomy and nonsplenectomy cohorts within the splenic injury patients. In comparison with the control cohort, patients undergoing splenectomy for splenic injury exhibited an elevated risk of ACS.