Chen Yu-Yen, Sheu Shwu-Jiuan, Hu Hsiao-Yun, Chu Dachen, Chou Pesus
School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Department of Ophthalmology, National Yang-Ming University Hospital, Yilan City, Yilan County, Taiwan.
PLoS One. 2017 Sep 12;12(9):e0184016. doi: 10.1371/journal.pone.0184016. eCollection 2017.
To investigate a possible association between retinal vein occlusion (RVO) and an increased risk of developing acute myocardial infarction (AMI).
A population-based retrospective cohort study using the entire population of the Taiwan National Health Insurance Research Database (NHIRD) from 1st January, 2001 to 31st December, 2013.
A total of 37921 subjects with RVO were enrolled in the RVO group, and 113763 subjects without RVO were enrolled in the comparison group. The comparison group consisted of randomly selected individuals who were propensity score (PS)-matched with the RVO group at a ratio of 1:3, based on age, gender, obesity, stroke, hyperviscosity syndrome, glaucoma, and the use of antithrombotic drugs. A log-rank test was used to compare the cumulative hazard of AMI between the two groups. A multivariate Cox regression analysis was used to estimate the adjusted hazard ratios (HRs) of AMI, adjusted for PS, diabetes, hypertension, hyperlipidemia, congestive heart failure, and chronic renal failure.
The mean age of the cohort was 62.4±13.2 years. RVO patients had significantly higher proportions of diabetes, hypertension, hyperlipidemia, congestive heart failure, and chronic renal failure than the comparisons. The mean follow-up period was 5.52 years in the RVO group and 5.55 years in the comparison group (p = 0.16). A log-rank test comparing the cumulative hazard curves of AMI for the two groups revealed a significant difference (p<0.0001). In the multivariate Cox regression after adjustment for PS and confounders, the RVO group had a significantly higher risk of AMI (adjusted HR = 1.21; 95% CI: 1.13 to 1.30). When the RVO group was divided into central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO) and analyzed separately, both groups had significantly higher adjusted HRs for developing AMI than the comparison group. Moreover, the CRVO group had a significantly higher risk of AMI than the BRVO group.
People with RVO are at significantly greater risk of developing AMI than individuals without RVO.
探讨视网膜静脉阻塞（RVO）与急性心肌梗死（AMI）发病风险增加之间的可能关联。
一项基于人群的回顾性队列研究，使用台湾国民健康保险研究数据库（NHIRD）2001年1月1日至2013年12月31日的全部人群。
RVO组共纳入37921例RVO患者，对照组纳入113763例无RVO的受试者。对照组由根据年龄、性别、肥胖、中风、高黏滞血症、青光眼和抗血栓药物使用情况按1:3比例与RVO组进行倾向评分（PS）匹配的随机选择个体组成。采用对数秩检验比较两组间AMI的累积风险。采用多变量Cox回归分析估计调整后的AMI风险比（HR），并对PS、糖尿病、高血压、高脂血症、充血性心力衰竭和慢性肾衰竭进行调整。
队列的平均年龄为62.4±13.2岁。RVO患者的糖尿病、高血压、高脂血症、充血性心力衰竭和慢性肾衰竭比例显著高于对照组。RVO组的平均随访期为5.52年，对照组为5.55年（p = 0.16）。比较两组AMI累积风险曲线的对数秩检验显示存在显著差异（p<0.0001）。在调整PS和混杂因素后的多变量Cox回归中，RVO组发生AMI的风险显著更高（调整后HR = 1.21；95%CI：1.13至1.30）。当将RVO组分为视网膜中央静脉阻塞（CRVO）和视网膜分支静脉阻塞（BRVO）并分别进行分析时，两组发生AMI的调整后HR均显著高于对照组。此外，CRVO组发生AMI的风险显著高于BRVO组。
与无RVO的个体相比，RVO患者发生AMI的风险显著更高。
