Ding Dah-Ching, Tsai I-Ju, Hsu Chung Y, Wang Jen-Hung, Lin Shinn-Zong
Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation Institute of Medical Sciences, Tzu Chi University, Hualien Management Office for Health Data, China Medical University Hospital Graduate Institute of Clinical Medical Science, China Medical University, Taichung Department of Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
Medicine (Baltimore). 2018 Apr;97(16):e0421. doi: 10.1097/MD.0000000000010421.
Hysterectomy is a common procedure for benign pathologies of the uterus. Reduced production of estrogen following hysterectomy has been reported. Yet the association between hysterectomy and coronary artery disease (CAD) risk remains controversial. The aim of this study was to investigate the effect of hysterectomy on the risk of CAD; calculations were adjusted for traditional risk factors.This study used a 1 million patient cohort of the Taiwan National Health Insurance database and included a total of 7331 women who received hysterectomy from 2000 to 2013. We randomly selected a control group composed of 29,324 women without hysterectomy by 1:4 matching the age (exact year) with the hysterectomy group.The mean (standard deviation) age was 43.5 ± 4.0 in the hysterectomy and 43.6 ± 4.0 in the control group. A total of 1986 CAD cases developed in both groups during a median follow-up of 7 years. Significant differences were observed in CAD incidence in the hysterectomy versus control group (9.82 vs. 7.17/1000 person-years, P < .001, adjusted hazard ratio = 1.31 [95% confidence interval: 1.18-1.45]).We found a significant association between hysterectomy and CAD, even after adjustment for baseline CAD risk factors.
子宫切除术是治疗子宫良性病变的常见手术。据报道，子宫切除术后雌激素分泌减少。然而，子宫切除术与冠状动脉疾病（CAD）风险之间的关联仍存在争议。本研究的目的是调查子宫切除术对CAD风险的影响；计算结果针对传统风险因素进行了调整。本研究使用了台湾国民健康保险数据库中的100万患者队列，纳入了2000年至2013年期间共7331名接受子宫切除术的女性。我们通过按年龄（精确年份）1:4匹配子宫切除组，随机选择了一个由29324名未接受子宫切除术的女性组成的对照组。子宫切除组的平均（标准差）年龄为43.5±4.0岁，对照组为43.6±4.0岁。在中位随访7年期间，两组共发生1986例CAD病例。子宫切除组与对照组的CAD发病率存在显著差异（9.82 vs. 7.17/1000人年，P<0.001，调整后的风险比=1.31 [95%置信区间：1.18 - 1.45]）。我们发现，即使在对基线CAD风险因素进行调整后，子宫切除术与CAD之间仍存在显著关联。
