Lee Chia-Yi, Yang Shun-Fa, Huang Jing-Yang, Chang Chao-Kai
Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
Nobel Eye Institute, Taipei, Taiwan.
Int J Med Sci. 2025 Jan 1;22(2):252-259. doi: 10.7150/ijms.101733. eCollection 2025.
To evaluate the association between coronary heart disease (CHD) severity and the risk of developing keratopathy. A retrospective cohort study was conducted with data from the Taiwan National Health Insurance Research Database (NHIRD). A total of 593100, 593100 and 296500 patients were included in the control, mild CHD and severe CHD groups, respectively. The primary outcomes were the development of superficial keratopathy and infectious keratitis with antibiotic usage. Cox proportional hazard regression was used to calculate the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for the primary outcomes among the groups. A total of 30697, 32134, and 15977 superficial keratopathy episodes and 6021, 6010, and 2982 infectious keratitis episodes were recorded in the control, mild CHD, and severe CHD groups, respectively. The incidence of superficial keratopathy was significantly greater in the severe CHD group (P = 0.037), and both groups presented a greater risk of developing superficial keratopathy than did the control group (both P < 0.05). The cumulative incidence of superficial keratopathy was also significantly greater in the severe CHD group than in the mild CHD group (P < 0.001). In the subgroup analyses, the incidence of superficial keratopathy was significantly greater in severe CHD patients than in mild CHD patients older than 70 years, and the correlation between CHD severity and superficial keratopathy incidence was significantly greater in those older than 70 years of age (P = 0.002). Severe CHD is related to a greater risk of developing superficial keratopathy, especially in those older than 70 years of age.
评估冠心病（CHD）严重程度与发生角膜病变风险之间的关联。利用台湾国民健康保险研究数据库（NHIRD）的数据进行了一项回顾性队列研究。对照组、轻度冠心病组和重度冠心病组分别纳入了593100、593100和296500例患者。主要结局为浅表性角膜病变的发生以及使用抗生素治疗的感染性角膜炎。采用Cox比例风险回归分析计算各组主要结局的校正风险比（aHRs）和95%置信区间（CIs）。对照组、轻度冠心病组和重度冠心病组分别记录了30697、32134和15977例浅表性角膜病变发作，以及6021、6010和2982例感染性角膜炎发作。重度冠心病组浅表性角膜病变的发生率显著更高（P = 0.037），且两组发生浅表性角膜病变的风险均高于对照组（P均< 0.05）。重度冠心病组浅表性角膜病变的累积发生率也显著高于轻度冠心病组（P < 0.001）。在亚组分析中，重度冠心病患者浅表性角膜病变的发生率显著高于70岁以上的轻度冠心病患者，且在70岁以上人群中冠心病严重程度与浅表性角膜病变发生率之间的相关性显著更高（P = 0.002）。重度冠心病与发生浅表性角膜病变的风险更高相关，尤其是在70岁以上的人群中。
