Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan.
School of Public Health, National Defense Medical Center, Taipei City, Taiwan.
Front Immunol. 2022 Mar 25;13:843796. doi: 10.3389/fimmu.2022.843796. eCollection 2022.
Ankylosing spondylitis (AS) is a risk factor for acute coronary syndrome (ACS). However, the influence of infectious insults, such as endophthalmitis, on the risk of ACS among AS patients has not been studied yet. In this study, we aimed to investigate the relationship between endophthalmitis in patients with AS and the incidence of ACS.
This retrospective cohort study extracted medical records from the Taiwan Longitudinal Health Insurance Database (LHID) from January 1, 2000, to December 31, 2015. The primary outcome was the incidence of ACS. Univariate and multivariate Cox regression analyses with and without Fine and Gray's competing risk model and Kaplan-Meier survival curve were used for the analyses. Spearman's rank correlation coefficient was performed for sensitivity analysis.
We identified 530 AS patients with endophthalmitis and 2,120 AS patients without endophthalmitis for comparison. The incidence rate of endophthalmitis in our study population was 2.66%. The overall incidence rate of ACS was 1,595.96 per 100,000 person-years in AS patients with endophthalmitis and 953.96 per 100,000 person-years in AS patients without endophthalmitis (adjusted HR = 1.787; 95% CI: 1.594-2.104, < 0.001). In comparison to those without comorbidities, higher adjusted HRs were found in AS patients with endophthalmitis and comorbidities such as diabetes mellitus, hyperlipidemia, hypertension, cerebrovascular accident, congestive heart failure, chronic obstructive pulmonary disease, asthma, and coronary artery disease. Besides, the age ≥ 60 years revealed a high risk for ACS in AS patients with endophthalmitis.
Endophthalmitis was found to be an independent risk factor for ACS in patients with AS. Further clinical studies are required to elucidate the underlying mechanisms and status of systemic inflammation during endophthalmitis.
强直性脊柱炎（AS）是急性冠状动脉综合征（ACS）的危险因素。然而，感染性损伤（如眼内炎）对 AS 患者 ACS 风险的影响尚未得到研究。在本研究中，我们旨在探讨 AS 患者眼内炎与 ACS 发生率之间的关系。
本回顾性队列研究从 2000 年 1 月 1 日至 2015 年 12 月 31 日从台湾纵向健康保险数据库（LHID）中提取病历。主要结局是 ACS 的发生率。使用单变量和多变量 Cox 回归分析以及 Fine 和 Gray 的竞争风险模型和 Kaplan-Meier 生存曲线进行分析。进行 Spearman 秩相关系数分析以进行敏感性分析。
我们确定了 530 例 AS 伴眼内炎患者和 2120 例 AS 无眼内炎患者进行比较。我们研究人群的眼内炎发生率为 2.66%。AS 伴眼内炎患者的 ACS 总发生率为每 100000 人年 1595.96 例，AS 无眼内炎患者为每 100000 人年 953.96 例（调整后的 HR = 1.787；95%CI：1.594-2.104，<0.001）。与无合并症的患者相比，AS 伴眼内炎和合并症（如糖尿病、高脂血症、高血压、中风、充血性心力衰竭、慢性阻塞性肺疾病、哮喘和冠心病）的患者的调整后 HR 更高。此外，年龄≥60 岁的 AS 伴眼内炎患者发生 ACS 的风险较高。
眼内炎被发现是 AS 患者 ACS 的独立危险因素。需要进一步的临床研究来阐明眼内炎期间潜在的全身炎症机制和状态。
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