Chang Yuh-Shin, Chu Chin-Chen, Weng Shih-Feng, Chang Chun, Wang Jhi-Joung, Jan Ren-Long
Department of Ophthalmology, Chi Mei Medical Center, Tainan, Taiwan.
Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan Departments of Recreation and Health-Care Management, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan.
Br J Ophthalmol. 2015 Feb;99(2):227-31. doi: 10.1136/bjophthalmol-2014-305451. Epub 2014 Aug 21.
To investigate the risk of acute coronary syndrome (ACS) following retinal artery occlusion (RAO).
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.
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.
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.
探讨视网膜动脉阻塞（RAO）后急性冠状动脉综合征（ACS）的风险。
研究队列包括2000年台湾纵向健康保险数据库中1999年1月至2008年12月期间诊断为RAO的所有患者（n = 688）。对照组包括从同一数据库中随机选取的患者（n = 4128），使用倾向评分在年龄、性别、合并糖尿病、高血压、高脂血症、慢性肾病和心房颤动状态方面与研究组进行匹配。采用Kaplan-Meier分析计算无ACS生存率。使用Cox比例风险回归分析在调整潜在混杂因素后获得ACS的调整后HR。比较RAO组和对照组之间ACS的发生率和风险。
随访期间，RAO组37例患者（5.38%）和138例对照组患者（3.34%）发生ACS（p = 0.0063），RAO组ACS风险显著更高（HR = 1.67，95%CI 1.16至2.40）。在调整潜在混杂因素后，RAO组发生ACS的HR比对照组高1.72倍（95%CI 1.20至2.47）。按RAO类型分层时，中央RAO亚组ACS的调整后HR为3.57（95%CI 2.09至6.10）。
我们发现RAO增加了ACS的风险。我们建议对RAO患者进行全面的心血管随访检查和ACS的医学预防。
