The risk of acute coronary syndrome after retinal artery occlusion: a population-based cohort study
The risk of acute coronary syndrome after retinal artery occlusion: a population-based cohort study
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DOI：
10.1136/bjophthalmol-2014-305451
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发表时间：
2015-02-01
影响因子：
4.1
通讯作者：
Jan, Ren-Long
中科院分区：
文献类型：
--
作者：
Chang, Yuh-Shin;Chu, Chin-Chen;Jan, Ren-Long
目的探讨视网膜动脉阻塞（RAO）并发急性冠状动脉综合征（ACS）的危险性。对照组包括从同一数据库中随机选择的患者（n=4128），这些患者使用倾向评分与研究组相匹配，包括年龄、性别和合并糖尿病、高血压、高血脂、慢性肾脏疾病和房颤状态。使用Kaplan-Meier分析计算无ACS生存率。校正潜在混杂因素后，采用考克斯比例风险回归分析获得ACS的校正HR。结果RAO组37例（5.38%）和对照组138例（3.34%）在随访期间发生ACS（p=0.0063），导致RAO组发生ACS的风险显著高于对照组（HR=1.67，95%CI 1.16 ~ 2.40）。校正潜在混杂因素后，RAO组发生ACS的HR是对照组的1.72倍（95%CI 1.20 - 2.47）。当按RAO类型分层时，中心RAO亚组ACS的校正HR为3.57（95%CI 2.09至6.10）。结论我们发现RAO增加了ACS的风险。我们建议对RAO后患者进行彻底的心血管检查和ACS的药物预防。
Aim To investigate the risk of acute coronary syndrome (ACS) following retinal artery occlusion (RAO).Methods The study cohort included all patients diagnosed with RAO between January 1999 and December 2008 (n=688) in the Taiwan Longitudinal Health Insurance Database 2000. The control group included randomly selected patients (n=4128) from the same database that were matched to the study group, using a propensity score, for age, gender, and comorbid diabetes mellitus, hypertension, hyperlipidaemia, chronic renal disease and atrial fibrillation status. The ACS-free survival rate was calculated using Kaplan-Meier analysis. Cox proportional hazard regression analysis was used to obtain the adjusted HR for ACS after adjustment for potential confounding factors. The incidence and risk of ACS were compared between the RAO and control groups.Results Thirty-seven patients in the RAO group (5.38%) and 138 controls (3.34%) had ACS (p=0.0063) during the follow-up period, resulting in a significantly higher risk of ACS in the RAO group (HR=1.67, 95% CI 1.16 to 2.40). After adjustment for potential confounders, the HR for developing ACS in the RAO group was 1.72 (95% CI 1.20 to 2.47) times higher than that of controls. When stratified by RAO type, the adjusted HR for ACS was 3.57 (95% CI 2.09 to 6.10) for the central RAO subgroup.Conclusions We found that RAO increased the risk for ACS. We recommend thorough follow-up cardiovascular examinations and medical prevention for ACS in patients following RAO.