Chang Chao-Feng, Chien Wu-Chien, Chung Chi-Hsiang, Lin Hsuan-Hwai, Huang Tien-Yu, Chen Peng-Jen, Chang Wei-Kuo, Huang Hsin-Hung
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei City 114, Taiwan.
Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei City 114, Taiwan.
J Clin Med. 2022 Jun 29;11(13):3765. doi: 10.3390/jcm11133765.
Performing esophagogastroduodenoscopy (EGD) in recently occurring peri-coronary artery disease (CAD) accident settings is always a dilemma. This study used the Taiwan National Health Insurance Research Database to identify patients with CAD and gastrointestinal bleeding who had received EGD or not between 2000 and 2013.The final population included in this study was 15,147 individuals, with 3801 individuals having received EGD (study cohort group) and 11,346 individuals not having received EGD (comparison cohort group). We initially performed a sensitivity test for CAD recurrence-related factors using multivariable Cox regression during the tracking period. A relatively earlier EGD intervention within one week demonstrated a lower risk of CAD recurrence (adjusted HR = 0.712). Although there were no significant differences in the overall tracking period, the adjusted HR of CAD recurrence was still lower in patients in the EGD group. Furthermore, our findings revealed that there were no remarkably short intervals to CAD recurrence in the study group. The Kaplan-Meier survival curve demonstrated that individuals who underwent EGD were not associated with a significantly increased CAD recurrence rate compared with the control (Log-rank test, = 0.255). CAD recurrence is always an issue in recent episodes of peri-CAD accident settings while receiving EGD. However, there is not a higher risk in comparison with the normal population in our study, and waiting periods may not be required.
在近期发生冠状动脉疾病（CAD）意外的情况下进行食管胃十二指肠镜检查（EGD）一直是一个两难的问题。本研究利用台湾国民健康保险研究数据库，识别出2000年至2013年间患有CAD和胃肠道出血且接受或未接受EGD的患者。本研究纳入的最终人群为15147人，其中3801人接受了EGD（研究队列组），11346人未接受EGD（对照队列组）。在随访期间，我们首先使用多变量Cox回归对CAD复发相关因素进行了敏感性测试。在一周内进行相对较早的EGD干预显示CAD复发风险较低（调整后HR = 0.712）。尽管在整个随访期间没有显著差异，但EGD组患者CAD复发的调整后HR仍然较低。此外，我们的研究结果显示，研究组中CAD复发的间隔时间并没有明显缩短。Kaplan-Meier生存曲线表明，与对照组相比，接受EGD的个体CAD复发率没有显著增加（对数秩检验，P = 0.255）。在近期CAD意外发作期间接受EGD时，CAD复发始终是一个问题。然而，在我们的研究中，与正常人群相比，风险并不更高，可能不需要等待期。
