Lin Yi-Ting, Chen Hsuan-Ju, Chen Pei-Chun, Sung Fung-Chang
1 Department of Emergency Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan.
2 Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
Angiology. 2019 Jan;70(1):41-46. doi: 10.1177/0003319718757615. Epub 2018 Feb 14.
Studies evaluating the risk of peripheral arterial disease (PAD) in patients with abdominal aortic aneurysm (AAA) are limited. We used insurance claims data of Taiwan to establish a cohort of 6590 patients with AAA newly diagnosed from 2000 to 2008 and 6590 controls without AAA matched by propensity score. The subsequent incidence density rates of PAD were estimated in both cohorts by the end of 2011, and the AAA cohort to the non-AAA cohort hazard ratios (HRs) of PAD were calculated using Cox proportional hazards models. The incidence density of PAD in the AAA cohort was 3.7-fold greater than that in the non-AAA cohort (14.1 vs 3.66 per 1000 person-years) with an adjusted HR of 3.56 (95% confidence interval [CI] = 2.89-4.39). For those without comorbidities, PAD in the AAA cohort was 7.4-fold greater than that in the non-AAA cohort (12.0 vs 1.61 per 1000 person-years) with an adjusted HR of 6.70 (95% CI = 4.43-10.1). The incidence of PAD in patients with ruptured AAA was lower than that in patients without rupture (6.95 vs 15.0 per 1000 person-years). This study demonstrates that patients with AAA are at increased risk of developing PAD.
评估腹主动脉瘤（AAA）患者外周动脉疾病（PAD）风险的研究有限。我们利用台湾的保险理赔数据，建立了一个由2000年至2008年新诊断出的6590例AAA患者和6590例倾向评分匹配的无AAA对照组成的队列。到2011年底，对两个队列中PAD的后续发病密度率进行了估计，并使用Cox比例风险模型计算了AAA队列与非AAA队列的PAD风险比（HRs）。AAA队列中PAD的发病密度比非AAA队列高3.7倍（每1000人年分别为14.1和3.66），调整后的HR为3.56（95%置信区间[CI]=2.89-4.39）。对于无合并症的患者，AAA队列中PAD的发病率比非AAA队列高7.4倍（每1000人年分别为12.0和1.61），调整后的HR为6.70（95%CI=4.43-10.1）。破裂性AAA患者的PAD发病率低于未破裂患者（每1000人年分别为6.95和15.0）。这项研究表明，AAA患者发生PAD的风险增加。
