Lee Chia-Yi, Yang Shun-Fa, Huang Jing-Yang, Chang Chao-Kai
Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan.
Nobel Eye Institute, Taipei 115, Taiwan.
Diagnostics (Basel). 2024 Mar 10;14(6):586. doi: 10.3390/diagnostics14060586.
This study aimed to evaluate the potential association between coronary heart disease (CHD) severity and the subsequent dry eye disease (DED) with a different severity through the use of the National Health Insurance Research Database (NHIRD) of Taiwan. A retrospective cohort study was conducted. The CHD population was further divided into a severe CHD that had received coronary artery bypass graft (CABG) surgery group and a mild CHD that had received medicine group, then matched with a 1:2 ratio, and 29,852 and 14,926 CHD patients were put into the severe CHD and mild CHD groups, respectively. The primary outcomes were the development of DED and severe DED after CHD diagnosis. The Cox proportional hazards regression was used to produce the adjusted hazard ratio (aHR) and 95% confidence interval (CI) of DED and severe DED between groups. There were 3440 and 1276 DED cases in the mild CHD and severe CHD groups, respectively. And another 37 and 48 severe CHD events were observed in the mild and severe CHD groups, respectively. The incidence of severe DED in the severe CHD group was significantly higher compared to the mild CHD group (aHR: 5.454, 95% CI: 1.551-7.180, = 0.0001). The cumulative probabilities of DED and severe DED were significantly higher in the severe CHD group than the mild CHD group (both < 0.0001). In the subgroup analysis, the correlation between severe CHD and DED was higher in the patients aged older than 70 years ( < 0.0001). In conclusion, severe CHD is associated with a higher incidence of severe DED with a higher cumulative incidence.
本研究旨在通过使用台湾地区国民健康保险研究数据库（NHIRD），评估冠心病（CHD）严重程度与随后不同严重程度的干眼症（DED）之间的潜在关联。进行了一项回顾性队列研究。冠心病患者群体进一步分为接受冠状动脉旁路移植术（CABG）的严重冠心病组和接受药物治疗的轻度冠心病组，然后按1:2的比例进行匹配，分别有29852例和14926例冠心病患者被纳入严重冠心病组和轻度冠心病组。主要结局是冠心病诊断后干眼症和严重干眼症的发生情况。采用Cox比例风险回归分析得出两组之间干眼症和严重干眼症的调整后风险比（aHR）及95%置信区间（CI）。轻度冠心病组和严重冠心病组分别有3440例和1276例干眼症病例。在轻度和严重冠心病组中，分别观察到另外37例和48例严重冠心病事件。严重冠心病组严重干眼症的发生率显著高于轻度冠心病组（aHR：5.454，95%CI：1.551 - 7.180， = 0.0001）。严重冠心病组干眼症和严重干眼症的累积概率显著高于轻度冠心病组（均 < 0.0001）。在亚组分析中，年龄大于70岁的患者中，严重冠心病与干眼症之间的相关性更高（ < 0.0001）。总之，严重冠心病与严重干眼症的较高发生率及较高累积发生率相关。
