Tseng Chun-Hung, Chen Jiunn-Horng, Lin Cheng-Li, Kao Chia-Hung
Department of Neurology, China Medical University Hospital, Taichung, Taiwan.
Allergy Asthma Proc. 2015 Nov-Dec;36(6):e106-12. doi: 10.2500/aap.2015.36.3891.
Chronic inflammation that triggers endothelial dysfunction and atherosclerosis may promote the evolution of cardiovascular diseases, including acute ischemic stroke (AIS). In this study, we assessed the association between rhinitis (RN), an immunoglobulin E-related atopic disease, and the risk of AIS.
We used a Taiwan national insurance claims data set of 1 million enrollees to distinguish 61,899 patients with RN and 123,798 randomly selected age- and sex-matched controls from January 1, 2000, to December 31, 2010. Both cohorts were followed up until the occurrence of stroke or the end of follow-up. The risk of AIS was evaluated by using the Cox proportional hazards regression model.
After adjustment of the relevant covariates, the RN group showed a lower risk of AIS (adjusted hazard ratio [aHR] 0.74 [95% confidence interval {CI}, 0.70-0.79]) compared with the control cohort at the end of follow-up. Among the participants without comorbidities, the RN cohort still had a lower risk of AIS compared with the control cohort (aHR 0.69 [95% CI, 0.59-0.81]). Moreover, in the three stratified age groups, RN was associated with a significantly decreased risk of AIS (ages ≤49 years: aHR 0.77 [95% CI, 0.63-0.95]; ages 50-64 years: aHR 0.72 [95% CI, 0.64-0.81]; ages ≥65 years: aHR 0.78 [95% CI, 0.71-0.85]).
RN was associated with a decreased risk of developing AIS. Although a reduction in risk of AIS was observed, it warrants further consideration to prevent AIS in patients with RN.
引发内皮功能障碍和动脉粥样硬化的慢性炎症可能会促进心血管疾病的发展,包括急性缺血性中风(AIS)。在本研究中,我们评估了与免疫球蛋白E相关的特应性疾病鼻炎(RN)与AIS风险之间的关联。
我们使用了一个包含100万参保人的台湾国民保险理赔数据集,从2000年1月1日至2010年12月31日,区分出61899例患有RN的患者和123798例随机选取的年龄和性别匹配的对照。两个队列均随访至中风发生或随访结束。使用Cox比例风险回归模型评估AIS风险。
在调整相关协变量后,随访结束时,与对照组相比,RN组发生AIS的风险较低(调整后风险比[aHR]为0.74[95%置信区间{CI},0.70 - 0.79])。在无合并症的参与者中,与对照组相比,RN队列发生AIS的风险仍然较低(aHR为0.69[95%CI,0.59 - 0.81])。此外,在三个分层年龄组中,RN与AIS风险显著降低相关(年龄≤49岁:aHR为0.77[95%CI,0.63 - 0.95];年龄50 - 64岁:aHR为0.72[95%CI,0.64 - 0.81];年龄≥65岁:aHR为0.78[95%CI,0.71 - 0.85])。
RN与发生AIS的风险降低相关。尽管观察到AIS风险降低,但仍需进一步考虑预防RN患者发生AIS。