Wong Chung-Shun, Lin Ying-Chin, Sung Li-Chin, Chen Tzu-Ting, Ma Hon-Ping, Hsu Yung-Ho, Tsai Shin-Han, Lin Yuh-Feng, Wu Mei-Yi
Department of Emergency Medicine, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan.
Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
PLoS One. 2017 Apr 25;12(4):e0176465. doi: 10.1371/journal.pone.0176465. eCollection 2017.
Carbon monoxide (CO) poisoning may cause toxicity to the cardiovascular system. However, the association between CO poisoning and the risk of major adverse cardiovascular events (MACE) remains unestablished. We investigated the incidence of MACE after CO poisoning in Taiwan and evaluated whether CO-poisoned individuals had a higher risk of MACE than did the general population.
Using Taiwan's National Health Insurance Research Database (NHIRD) during 2005-2013, a nationwide population-based cohort study was conducted among patients who experienced CO poisoning between 2005 and 2013. CO poisoning was defined according to the International Classification of Diseases, Ninth Revision, Clinical Modification codes. The study cohort comprised patients with CO poisoning between 2005 and 2010 (N = 13,939). Each patient was matched according to age, sex and index date with four randomly selected controls from the comparison cohort (N = 55,756). All patients were followed from the study date until MACE development, death, or the end of 2013. The hazard ratios for MACE were compared between the two cohorts by using Cox proportional hazards regressions analyses.
Incident cases of MACE were identified from the NHIRD. After adjustment for potential confounders, the study cohort was independently associated with a higher MACE risk (adjusted hazard ratio, 2.00; 95% confidence interval, 1.83-2.18).
This population-based cohort study indicated that patients with CO poisoning have a higher risk of MACE than do individuals without CO poisoning.
一氧化碳（CO）中毒可能会对心血管系统产生毒性作用。然而，CO中毒与主要不良心血管事件（MACE）风险之间的关联尚未明确。我们调查了台湾地区CO中毒后MACE的发生率，并评估了CO中毒患者发生MACE的风险是否高于普通人群。
利用2005 - 2013年台湾地区国民健康保险研究数据库（NHIRD），对2005年至2013年间发生CO中毒的患者进行了一项基于全国人群的队列研究。CO中毒根据国际疾病分类第九版临床修订本代码进行定义。研究队列包括2005年至2010年间发生CO中毒的患者（N = 13,939）。根据年龄、性别和索引日期，为每位患者从对照队列中随机选取4名对照（N = 55,756）进行匹配。所有患者从研究日期开始随访，直至发生MACE、死亡或2013年底。通过Cox比例风险回归分析比较两个队列中MACE的风险比。
从NHIRD中识别出MACE的发病病例。在对潜在混杂因素进行调整后，研究队列与更高的MACE风险独立相关（调整后的风险比为2.00；95%置信区间为1.83 - 2.18）。
这项基于人群的队列研究表明，CO中毒患者发生MACE的风险高于未发生CO中毒的个体。
