Carbon Monoxide Poisoning and Developing Ischemic Heart Disease: A Nationwide Population-Based Nested Case-Control Study

Abstract

Although there are several case reports showing that carbon monoxide (CO) poisoning causes ischemic heart disease (IHD), no large-scale epidemiological studies have shown a significant association between the two. To investigate the association between CO poisoning and IHD, a nested case-control study of 28,113 patients who experienced CO poisoning and 28,113 controls matched by sex and age was performed using the nationwide health database of South Korea. Based on a conditional logistic regression, there was a significantly higher risk of IHD among the CO poisoning group than among the control group (adjusted hazard ratio [HR], 2.16; 95% confidence interval [CI], 1.87–2.49). The risk of IHD after CO poisoning was higher among the younger age group under 40 years (adjusted HR, 4.85; 95% CI, 3.20–7.35), and it was much greater among those with comorbidities (adjusted HR, 10.69; 95% CI, 2.41–47.51). The risk of IHD was the highest within the first two years after CO poisoning (adjusted HR, 11.12; 95% CI, 4.54–27.22). Even if more than six years had passed, the risk was still significantly higher than among the control group (adjusted HR, 1.55; 95% CI, 1.27–1.89). The analyses imply that CO poisoning is associated with an increased risk of IHD.

A patient with toxic encephalopathy associated with acute carbon monoxide poisoning–A clinical case

“…In most published cases the MRI lesions in acute CO poisoning are located not only in the globus pallidus but are diffuse in the white matter [14,20], the cerebellar hemispheres, the hippocampus and the cerebral cortex [21]. Most of the patients will also have some laboratory or ECG indicators for heart damage but in our case there was only atrial fibrillation, which was transient [22].…”

Exploring Health Impacts of Occupational Exposure to Carbon Monoxide in the Labour Community of Hattar Industrial Estate

“…Consequently, carbon monoxide will bind hemoglobin preferentially over oxygen when both are present in the lungs. Even small amounts of carbon monoxide can dramatically reduce the ability of hemoglobin to transport oxygen [10]. Tissue damage results from local hypoxia.…”