Division of Cardiovascular Surgery, Department of Surgery, Cathay General Hospital, Taipei, Taiwan.
Division of Cardiovascular Surgery, Department of Surgery, Cathay General Hospital, Hsinchu Branch, Hsinchu, Taiwan.
Int Angiol. 2023 Aug;42(4):352-361. doi: 10.23736/S0392-9590.23.05053-8. Epub 2023 Jun 22.
Varicose veins (VV) and mitral valve regurgitation (MR) are both common diseases. The aim was to investigate whether VV are associated with an increased risk of MR.
We conducted a nationwide cohort study to assess the association between VV and risk of developing MR. Drawn from the Taiwan National Health Insurance Research Database (NHIRD), the records of 56,898 patients with VV (the VV cohort) and 56,898 propensity score-matched patients without VV (the non-VV cohort) in the years 2007 to 2015 were identified. Follow-up duration was calculated from the date of entry in the cohort until the occurrence of a first MR diagnosis, death, or the end of the observation period (December 31, 2015), whichever occurred first. Hazard ratios (HRs) and accompanying 95% confidence intervals (CIs) derived from the Cox proportional hazards model were used to estimate the association between VV and MR risks.
After multivariable adjustment, VV was associated with an increased risk of MR (adjusted HR, 1.63; 95% CI: 1.52-1.74). Notably, significant associations between VV and MR risk were evident in both genders and in all age groups. A trend of significant increase of MR risk was also observed with increasing frequency of annual clinical visits for VV. Within the VV cohort, the subgroup of MR presence had higher incidences of atrial fibrillation, heart failure, valve-related surgeries, and mortality (P<0.001).
This population-based cohort study revealed that VV was associated with an increased risk of MR in a Taiwanese population. Vigilance of MR existence should be emphasized in patients of VV due to its potentially poor long-term outcomes.
静脉曲张（VV）和二尖瓣反流（MR）都是常见疾病。本研究旨在探讨 VV 是否与 MR 风险增加相关。
我们进行了一项全国性队列研究，以评估 VV 与发生 MR 风险之间的关系。从台湾全民健康保险研究数据库（NHIRD）中，我们选取了 2007 年至 2015 年间 56898 例 VV 患者（VV 队列）和 56898 例匹配的无 VV 患者（非 VV 队列）的记录。随访时间从进入队列日期开始计算，直至首次发生 MR 诊断、死亡或观察期结束（2015 年 12 月 31 日），以先发生者为准。Cox 比例风险模型得出的风险比（HR）及其相应的 95%置信区间（CI）用于评估 VV 与 MR 风险之间的关系。
多变量调整后，VV 与 MR 风险增加相关（调整后的 HR，1.63；95%CI：1.52-1.74）。值得注意的是，在所有性别和年龄组中，VV 与 MR 风险之间均存在显著相关性。随着 VV 年临床就诊次数的增加，MR 风险显著增加的趋势也很明显。在 VV 队列中，MR 存在亚组的心房颤动、心力衰竭、瓣膜相关手术和死亡率更高（P<0.001）。
这项基于人群的队列研究表明，在台湾人群中，VV 与 MR 风险增加相关。由于 VV 可能导致不良的长期结局，因此应重视存在 MR 的 VV 患者。
