急性胰腺炎患者发生急性冠状动脉综合征的发生率和风险：一项全国性队列研究。
Incidence and risk of acute coronary syndrome in patients with acute pancreatitis: A nationwide cohort study.
机构信息
Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan; Department of Health Services Administration, China Medical University, Taichung, Taiwan; Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan.
Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan.
出版信息
Pancreatology. 2017 Sep-Oct;17(5):675-680. doi: 10.1016/j.pan.2017.07.189. Epub 2017 Jul 25.
BACKGROUND
Studies on the relationship between acute pancreatitis (AP) and acute coronary syndrome (ACS) are scant. We conducted a nationwide cohort study to investigate the incidence and risk of ACS in patients with AP.
METHODS
We enrolled patients newly diagnosed with AP between 2000 and 2010 from the Taiwan National Health Insurance Research Database and randomly selected a control cohort without a history of AP after frequency-matching for age, sex, and index year at a ratio of 4:1 for each patient with AP. The follow-up period was from the index date of new AP diagnosis to the diagnosis of ACS, censoring, or the end of 2011.
RESULTS
We assessed 87 068 patients in the AP cohort and 348 272 participants in the control cohort for 508 991 and 2 301 317 person-years, respectively. The AP cohort exhibited a higher overall incidence of ACS than the control cohort (5.44 vs 3.03 per 1000 person-y). After adjustment for sex, age, and comorbidities, the AP cohort exhibited a 1.24-fold higher adjusted hazard ratio (aHR) of ACS (95% confidence interval = 1.19-1.30) than did the control cohort. When stratified by age, the patients with AP aged ≤39 years presented a 2.37-fold higher aHR of ACS than did their corresponding controls (95% CI = 1.88-2.99). Approximate one third of ACS developed within 1 month of AP occurrence.
CONCLUSIONS
This nationwide cohort study indicated that patients with AP are at an increased risk of ACS compared with those without AP.
背景
急性胰腺炎 (AP) 与急性冠状动脉综合征 (ACS) 之间关系的研究较少。我们进行了一项全国性队列研究，以调查 AP 患者 ACS 的发病率和风险。
方法
我们从台湾全民健康保险研究数据库中招募了 2000 年至 2010 年间新诊断为 AP 的患者，并在年龄、性别和指数年份上与 AP 患者以 4:1 的比例随机选择了没有 AP 病史的对照组。随访期从新 AP 诊断的索引日期到 ACS 的诊断、截止或 2011 年底。
结果
我们评估了 AP 队列中的 87068 名患者和对照组中的 348272 名参与者，AP 队列的随访时间为 508991 人年，对照组为 2301317 人年。AP 队列的 ACS 总发生率高于对照组（5.44 比 3.03/1000 人年）。调整性别、年龄和合并症后，AP 队列 ACS 的调整后危险比（aHR）为 1.24（95%置信区间 1.19-1.30），高于对照组。按年龄分层时，年龄≤39 岁的 AP 患者 ACS 的 aHR 为对照组的 2.37 倍（95%CI 1.88-2.99）。大约三分之一的 ACS 在 AP 发生后 1 个月内发展。
结论
这项全国性队列研究表明，与无 AP 的患者相比，AP 患者发生 ACS 的风险增加。
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