Early acupuncture exposure and mortality in older adults with ischemic heart disease: A nationwide cohort study in Korea

Background: Cardiovascular disease is a leading cause of morbidity and mortality in older adults. However, older adults with ischemic heart disease (IHD) are often exposed to risks associated with polypharmacy, and standard treatments may not fully address their complex clinical needs. Therefore, integrative approaches, such as acupuncture, may play a complementary role. This study assessed the association between early acupuncture exposure and mortality among older adults with newly diagnosed IHD. Methods: Using the Korean National Health Insurance Service database, we identified patients aged ≥65 years with newly diagnosed IHD. Those receiving ≥6 acupuncture sessions within six months post-diagnosis formed the acupuncture group; those without any acupuncture formed the conventional group. Primary outcomes were five-year all-cause and circulatory system disease-specific mortality. Exploratory analyses compared regular and irregular acupuncture exposure. Results: Of 9865 patients, 667 received acupuncture. They were younger, included more females, and had more severe disabilities than the conventional group. After adjustment for confounders, the acupuncture group showed lower all-cause mortality (adjusted hazard ratio [aHR] 0.71, 95 % confidence interval [CI] 0.58–0.88) and circulatory system disease-specific mortality (aHR 0.54, 95 % CI 0.34–0.89). Regular acupuncture use conferred further survival benefits over irregular use and no acupuncture. Conclusions: These findings suggest that early-phase acupuncture intervention may play a meaningful role in improving survival outcomes in this population. Prospective studies are needed to confirm these findings and determine causality.