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The risk of acute coronary syndrome after retinal artery occlusion: a population-based cohort study
  1. Yuh-Shin Chang1,
  2. Chin-Chen Chu2,3,4,
  3. Shih-Feng Weng2,5,
  4. Chun Chang6,
  5. Jhi-Joung Wang2,3,
  6. Ren-Long Jan7,8
  1. 1Department of Ophthalmology, Chi Mei Medical Center, Tainan, Taiwan
  2. 2Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
  3. 3Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan
  4. 4Departments of Recreation and Health-Care Management, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan
  5. 5Hospital and Health Care Administration, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan
  6. 6Department of Education, University of Taipei, Taipei, Taiwan
  7. 7Department of Pediatrics, Chi Mei Medical Center, Liouying, Tainan, Taiwan
  8. 8Graduate Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan
  1. Correspondence to Dr Ren-Long Jan, Department of Pediatrics, Chi Mei Medical Center, Liouying, 201, Taikang, Taikang Village, Liouying District, Tainan 73657, Taiwan; renlongjan{at}gmail.com

Abstract

Aim To investigate the risk of acute coronary syndrome (ACS) following retinal artery occlusion (RAO).

Methods The study cohort included all patients diagnosed with RAO between January 1999 and December 2008 (n=688) in the Taiwan Longitudinal Health Insurance Database 2000. The control group included randomly selected patients (n=4128) from the same database that were matched to the study group, using a propensity score, for age, gender, and comorbid diabetes mellitus, hypertension, hyperlipidaemia, chronic renal disease and atrial fibrillation status. The ACS-free survival rate was calculated using Kaplan–Meier analysis. Cox proportional hazard regression analysis was used to obtain the adjusted HR for ACS after adjustment for potential confounding factors. The incidence and risk of ACS were compared between the RAO and control groups.

Results Thirty-seven patients in the RAO group (5.38%) and 138 controls (3.34%) had ACS (p=0.0063) during the follow-up period, resulting in a significantly higher risk of ACS in the RAO group (HR=1.67, 95% CI 1.16 to 2.40). After adjustment for potential confounders, the HR for developing ACS in the RAO group was 1.72 (95% CI 1.20 to 2.47) times higher than that of controls. When stratified by RAO type, the adjusted HR for ACS was 3.57 (95% CI 2.09 to 6.10) for the central RAO subgroup.

Conclusions We found that RAO increased the risk for ACS. We recommend thorough follow-up cardiovascular examinations and medical prevention for ACS in patients following RAO.

  • Retina
  • Epidemiology

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