主动脉瘤手术修复与随后心血管疾病诊断之间的关联。
Association between surgical repair of aortic aneurysms and the diagnosis of subsequent cardiovascular diseases.
机构信息
Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; School of Public Health, National Defense Medical Center, Taipei, Taiwan; Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan.
出版信息
J Cardiol. 2020 Jun;75(6):621-627. doi: 10.1016/j.jjcc.2019.12.005. Epub 2019 Dec 30.
BACKGROUND
Cardiovascular diseases (CVDs) and aortic aneurysms (AAs) share several clinical risk factors. However, the potential effects on future CVDs of surgical treatments involving the open surgical repair (OSR) of AAs are unknown. We hypothesize that the OSR of AAs is associated with subsequent CVDs.
METHODS
The data for this nationwide population-based retrospective cohort study were obtained from the National Health Insurance Research Database in Taiwan. The outcome assessed in this study was the cumulative incidence of CVDs in patients with AAs during a 14-year follow-up period, which was further stratified according to those who underwent OSR, endovascular aneurysm repair (EVAR), and nonsurgical treatment (NST).
RESULTS
Our analysis included 11,764 patients with AAs, of whom 2,524 received surgery and 2,524 were propensity score-matched controls. Compared to the controls, patients who received OSR exhibited a significantly decreased incidence of CVD development [adjusted hazard ratio (HR)=0.89,p=0.006]. Furthermore, compared to patients who received NST, patients who received OSR had a significantly lower incidence of subsequent acute myocardial infarction (adjusted HR=0.793, p=0.037).
CONCLUSIONS
Compared to NST, OSR of AAs could be associated with a lower incidence of subsequent CVDs.
背景
心血管疾病 (CVDs) 和主动脉瘤 (AAs) 有一些共同的临床危险因素。然而，涉及开放手术修复 (OSR) 的 AAs 的外科治疗对未来 CVDs 的潜在影响尚不清楚。我们假设 AAs 的 OSR 与随后的 CVDs 有关。
方法
这项全国范围内基于人群的回顾性队列研究的数据来自台湾的全民健康保险研究数据库。本研究评估的结果是在 14 年的随访期间，患有 AAs 的患者发生 CVDs 的累积发生率，根据接受 OSR、血管内动脉瘤修复 (EVAR) 和非手术治疗 (NST) 的患者进行进一步分层。
结果
我们的分析包括 11764 名患有 AAs 的患者，其中 2524 名接受了手术，2524 名接受了倾向评分匹配的对照组。与对照组相比，接受 OSR 的患者 CVD 发展的发生率显著降低[调整后的危险比 (HR)=0.89，p=0.006]。此外，与接受 NST 的患者相比，接受 OSR 的患者随后发生急性心肌梗死的发生率显著降低[调整后的 HR=0.793，p=0.037]。
结论
与 NST 相比，OSR 治疗 AAs 可能与随后 CVDs 的发生率降低有关。
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