{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T12:07:47Z","timestamp":1792066067703,"version":"4.4.0"},"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2023,12,6]],"date-time":"2023-12-06T00:00:00Z","timestamp":1701820800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>This study examined the long-term risks of heart failure (HF) and coronary heart disease (CHD) following traumatic brain injury (TBI), focusing on gender differences.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Data from Taiwan\u2019s National Health Insurance Research Database included 29,570 TBI patients and 118,280 matched controls based on propensity scores.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The TBI cohort had higher incidences of CHD and HF (9.76 vs. 9.07 per 1000 person-years; 4.40 vs. 3.88 per 1000 person-years). Adjusted analyses showed a significantly higher risk of HF in the TBI group (adjusted hazard ratio = 1.08, 95% CI = 1.01\u20131.17, P = 0.031). The increased CHD risk in the TBI cohort became insignificant after adjustment. Subgroup analysis by gender revealed higher HF risk in men (aHR = 1.14, 95% CI = 1.03\u20131.25, P = 0.010) and higher CHD risk in women under 50 (aHR = 1.32, 95% CI = 1.15\u20131.52, P &lt; 0.001). TBI patients without beta-blocker therapy may be at increased risk of HF.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Our results suggest that TBI increases the risk of HF and CHD in this nationwide cohort of Taiwanese citizens. Gender influences the risks differently, with men at higher HF risk and younger women at higher CHD risk. Beta-blockers have a neutral effect on HF and CHD risk.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0295416","type":"journal-article","created":{"date-parts":[[2023,12,6]],"date-time":"2023-12-06T18:41:36Z","timestamp":1701888096000},"page":"e0295416","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":12,"title":["Traumatic brain injury and risk of heart failure and coronary heart disease: A nationwide population-based cohort study"],"prefix":"10.1371","volume":"18","author":[{"given":"Ching-Hui","family":"Huang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao-Tung","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3172-8507","authenticated-orcid":true,"given":"Chia-Chu","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,12,6]]},"reference":[{"issue":"4","key":"pone.0295416.ref001","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.3171\/2017.10.JNS17352","article-title":"Estimating the global incidence of traumatic brain injury","volume":"130","author":"MC Dewan","year":"2018","journal-title":"Journal of neurosurgery"},{"issue":"6","key":"pone.0295416.ref002","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1097\/CRD.0000000000000167","article-title":"Brain-heart interactions in traumatic brain injury","volume":"25","author":"A El-Menyar","year":"2017","journal-title":"Cardiology in review"},{"issue":"7","key":"pone.0295416.ref003","doi-asserted-by":"crossref","first-page":"329","DOI":"10.5005\/jp-journals-10071-23208","article-title":"Head rules over the heart: cardiac manifestations of cerebral disorders","volume":"23","author":"AP Hrishi","year":"2019","journal-title":"Indian journal of critical care medicine: peer-reviewed, official publication of Indian Society of Critical Care Medicine"},{"issue":"10","key":"pone.0295416.ref004","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1056\/NEJMoa1406761","article-title":"Clinical features and outcomes of takotsubo (stress) cardiomyopathy","volume":"373","author":"C Templin","year":"2015","journal-title":"New England Journal of Medicine"},{"issue":"11","key":"pone.0295416.ref005","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1001\/jamaneurol.2022.2682","article-title":"Association Between Traumatic Brain Injury and Subsequent Cardiovascular Disease Among Post-9\/11\u2013Era Veterans","volume":"79","author":"IJ Stewart","year":"2022","journal-title":"JAMA neurology"},{"issue":"4","key":"pone.0295416.ref006","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2022.9478","article-title":"Association of traumatic brain injury with the risk of developing chronic cardiovascular, endocrine, neurological, and psychiatric disorders","volume":"5","author":"S Izzy","year":"2022","journal-title":"JAMA network open"},{"issue":"5","key":"pone.0295416.ref007","doi-asserted-by":"crossref","first-page":"653","DOI":"10.3390\/biology11050653","article-title":"Gender differences in takotsubo syndrome","volume":"11","author":"T Murakami","year":"2022","journal-title":"Biology"},{"issue":"5","key":"pone.0295416.ref008","doi-asserted-by":"crossref","first-page":"1325","DOI":"10.1016\/j.chest.2015.12.014","article-title":"Cardiac dysfunction after neurologic injury: what do we know and where are we going?","volume":"149","author":"V Krishnamoorthy","year":"2016","journal-title":"Chest"},{"issue":"1","key":"pone.0295416.ref009","doi-asserted-by":"crossref","first-page":"39","DOI":"10.5853\/jos.2022.02173","article-title":"The Heart Is at Risk: Understanding Stroke-Heart-Brain Interactions with Focus on Neurogenic Stress Cardiomyopathy\u2014A Review","volume":"25","author":"M Ziaka","year":"2023","journal-title":"Journal of stroke"},{"issue":"1","key":"pone.0295416.ref010","doi-asserted-by":"crossref","first-page":"e001051","DOI":"10.1136\/tsaco-2022-001051","article-title":"Beta blockers in traumatic brain injury: a systematic review and meta-analysis","volume":"8","author":"S Hart","year":"2023","journal-title":"Trauma Surgery & Acute Care Open"},{"issue":"3","key":"pone.0295416.ref011","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1377\/hlthaff.22.3.61","article-title":"Taiwan\u2019s new national health insurance program: genesis and experience so far","volume":"22","author":"T.-M. Cheng","year":"2003","journal-title":"Health affairs"},{"issue":"10","key":"pone.0295416.ref012","doi-asserted-by":"crossref","first-page":"e0206036","DOI":"10.1371\/journal.pone.0206036","article-title":"Menopausal symptoms and risk of coronary heart disease in middle-aged women: A nationwide population-based cohort study","volume":"13","author":"C-H Huang","year":"2018","journal-title":"PLoS One"},{"issue":"18","key":"pone.0295416.ref013","doi-asserted-by":"crossref","first-page":"1906","DOI":"10.1001\/2012.jama.11975","article-title":"Association between nucleoside analogues and risk of hepatitis B virus\u2013related hepatocellular carcinoma recurrence following liver resection","volume":"308","author":"C-Y Wu","year":"2012","journal-title":"Jama"},{"issue":"3","key":"pone.0295416.ref014","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/S0895-4356(02)00585-1","article-title":"How to measure comorbidity: a critical review of available methods","volume":"56","author":"V De Groot","year":"2003","journal-title":"Journal of clinical epidemiology"},{"key":"pone.0295416.ref015","doi-asserted-by":"crossref","first-page":"e740","DOI":"10.1016\/j.wneu.2018.10.130","article-title":"Traumatic brain injury increases the risk of major adverse cardiovascular and cerebrovascular events: a 13-year, population-based study","volume":"122","author":"T-TE Nyam","year":"2019","journal-title":"World neurosurgery"},{"key":"pone.0295416.ref016","doi-asserted-by":"crossref","first-page":"107119","DOI":"10.1016\/j.clineuro.2021.107119","article-title":"Takotsubo cardiomyopathy in post-traumatic brain injury: a systematic review of diagnosis and management","volume":"213","author":"SL Gruhl","year":"2022","journal-title":"Clinical Neurology and Neurosurgery"},{"issue":"5","key":"pone.0295416.ref017","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1016\/j.jacc.2007.03.050","article-title":"Four-year recurrence rate and prognosis of the apical ballooning syndrome","volume":"50","author":"AA Elesber","year":"2007","journal-title":"Journal of the American College of Cardiology"},{"key":"pone.0295416.ref018","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1007\/s00068-017-0779-5","article-title":"\u03b2-Blocker after severe traumatic brain injury is associated with better long-term functional outcome: a matched case control study","volume":"43","author":"R Ahl","year":"2017","journal-title":"European Journal of Trauma and Emergency Surgery"},{"issue":"13","key":"pone.0295416.ref019","doi-asserted-by":"crossref","first-page":"1834","DOI":"10.1089\/neu.2020.7484","article-title":"Concussion and risk of chronic medical and behavioral health comorbidities","volume":"38","author":"S Izzy","year":"2021","journal-title":"Journal of neurotrauma"},{"issue":"13\u201314","key":"pone.0295416.ref020","doi-asserted-by":"crossref","first-page":"1635","DOI":"10.3109\/02699052.2015.1075149","article-title":"Traumatic brain injury, coronary atherosclerosis and cardiovascular mortality","volume":"29","author":"N Ahmadi","year":"2015","journal-title":"Brain injury"},{"issue":"1","key":"pone.0295416.ref021","doi-asserted-by":"crossref","first-page":"5639","DOI":"10.1038\/s41598-018-23959-2","article-title":"Traumatic brain injury leads to accelerated atherosclerosis in apolipoprotein E deficient mice","volume":"8","author":"J Wang","year":"2018","journal-title":"Scientific Reports"},{"key":"pone.0295416.ref022","doi-asserted-by":"crossref","first-page":"621477","DOI":"10.3389\/fnins.2021.621477","article-title":"NETs lead to sympathetic hyperactivity after traumatic brain injury through the LL37-Hippo\/MST1 pathway","volume":"15","author":"K Zhu","year":"2021","journal-title":"Frontiers in Neuroscience"},{"issue":"9","key":"pone.0295416.ref023","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1016\/S1474-4422(17)30259-4","article-title":"Paroxysmal sympathetic hyperactivity: the storm after acute brain injury","volume":"16","author":"G Meyfroidt","year":"2017","journal-title":"The Lancet Neurology"},{"key":"pone.0295416.ref024","doi-asserted-by":"crossref","first-page":"1956","DOI":"10.1007\/s00415-017-8581-1","article-title":"Severity of traumatic brain injury correlates with long-term cardiovascular autonomic dysfunction","volume":"264","author":"MJ Hilz","year":"2017","journal-title":"Journal of neurology"},{"issue":"5","key":"pone.0295416.ref025","doi-asserted-by":"crossref","first-page":"e0285499","DOI":"10.1371\/journal.pone.0285499","article-title":"Beta1-receptor blockade attenuates atherosclerosis progression following traumatic brain injury in apolipoprotein E deficient mice","volume":"18","author":"J Wang","year":"2023","journal-title":"Plos one"},{"issue":"3","key":"pone.0295416.ref026","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1097\/SHK.0000000000000642","article-title":"Sympathoadrenal activation is associated with acute traumatic coagulopathy and endotheliopathy in isolated brain injury","volume":"46","author":"AP Di Battista","year":"2016","journal-title":"Shock (Augusta, Ga)"},{"issue":"7908","key":"pone.0295416.ref027","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1038\/s41586-022-04673-6","article-title":"Neuroimmune cardiovascular interfaces control atherosclerosis","volume":"605","author":"SK Mohanta","year":"2022","journal-title":"Nature"},{"issue":"1","key":"pone.0295416.ref028","doi-asserted-by":"crossref","first-page":"148","DOI":"10.3390\/jcm10010148","article-title":"Assessing the severity of traumatic brain injury\u2014time for a change?","volume":"10","author":"O Tenovuo","year":"2021","journal-title":"Journal of clinical medicine"},{"key":"pone.0295416.ref029","doi-asserted-by":"crossref","first-page":"1158483","DOI":"10.3389\/fnhum.2023.1158483","article-title":"Prevalence of comorbidities post mild traumatic brain injuries: a traumatic brain injury model systems study","volume":"17","author":"SK Sudhakar","year":"2023","journal-title":"Frontiers in Human Neuroscience"},{"issue":"5","key":"pone.0295416.ref030","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1097\/00001199-200609000-00001","article-title":"The epidemiology and impact of traumatic brain injury: a brief overview","volume":"21","author":"JA Langlois","year":"2006","journal-title":"The Journal of head trauma rehabilitation"},{"issue":"2","key":"pone.0295416.ref031","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1177\/0885066615616907","article-title":"Radiographic and clinical predictors of cardiac dysfunction following isolated traumatic brain injury","volume":"32","author":"AE Urdaneta","year":"2017","journal-title":"Journal of intensive care medicine"},{"key":"pone.0295416.ref032","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13049-016-0217-4","article-title":"Traumatic brain injury is not associated with significant myocardial dysfunction: an observational pilot study","volume":"24","author":"K Serri","year":"2016","journal-title":"Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine"},{"issue":"6","key":"pone.0295416.ref033","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1097\/CCM.0000000000002404","article-title":"Early systolic dysfunction following traumatic brain injury: a cohort study","volume":"45","author":"V Krishnamoorthy","year":"2017","journal-title":"Critical care medicine"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0295416","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,6]],"date-time":"2023-12-06T18:41:54Z","timestamp":1701888114000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0295416"}},"subtitle":[],"editor":[{"given":"Masaki","family":"Mogi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2023,12,6]]},"references-count":33,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2023,12,6]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0295416","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,6]]}}}