PDF(Pubmed)
Abstract：
BACKGROUND: Retinal artery occlusion (RAO) is a major cause of acute visual loss and patients with RAO have an increased risk for subsequent cardiovascular events. However, there is little evidence of whether the use of statins is associated with the prevention of cardiovascular events in patients with RAO. We investigated whether statin treatment in patients with RAO is associated with a lower risk of cardiovascular events.
METHODS: This study was a historical cohort study with nested case-control analysis. Using the nationwide health insurance claims database in Korea, we retrospectively established a cohort of newly diagnosed RAO patients without prior cardiovascular events between January 2008 and March 2020. We defined the case group as those who had cardiovascular events (stroke or myocardial infarction) and the control group as RAO patients without primary outcome matched by sex, age, comorbidities, and duration of follow-up (1:2 incidence density sampling). Conditional logistic regression was performed.
RESULTS: Among 13,843 patients newly diagnosed with RAO, 1030 patients had cardiovascular events (mean follow-up period of 6.4 ± 3.7 years). A total of 957 cases were matched to 1914 controls. Throughout the study period, the proportion of patients taking statin was less than half. Statin treatment after RAO was associated with a low risk of cardiovascular events (adjusted OR, 0.637; 95% CI 0.520-0.780; P < 0.001). A longer duration of statin exposure was associated with a lower cardiovascular risk.
CONCLUSIONS: In patients with newly diagnosed RAO, treatment with statins, particularly long-term use, was associated with a low risk of future cardiovascular events.
METHODS: This study was a historical cohort study with nested case-control analysis. Using the nationwide health insurance claims database in Korea, we retrospectively established a cohort of newly diagnosed RAO patients without prior cardiovascular events between January 2008 and March 2020. We defined the case group as those who had cardiovascular events (stroke or myocardial infarction) and the control group as RAO patients without primary outcome matched by sex, age, comorbidities, and duration of follow-up (1:2 incidence density sampling). Conditional logistic regression was performed.
RESULTS: Among 13,843 patients newly diagnosed with RAO, 1030 patients had cardiovascular events (mean follow-up period of 6.4 ± 3.7 years). A total of 957 cases were matched to 1914 controls. Throughout the study period, the proportion of patients taking statin was less than half. Statin treatment after RAO was associated with a low risk of cardiovascular events (adjusted OR, 0.637; 95% CI 0.520-0.780; P < 0.001). A longer duration of statin exposure was associated with a lower cardiovascular risk.
CONCLUSIONS: In patients with newly diagnosed RAO, treatment with statins, particularly long-term use, was associated with a low risk of future cardiovascular events.
摘要：
背景：视网膜动脉闭塞（RAO）是急性视力丧失的主要原因，RAO患者随后发生心血管事件的风险增加。然而,几乎没有证据表明他汀类药物的使用是否与RAO患者心血管事件的预防相关.我们调查了RAO患者的他汀类药物治疗是否与心血管事件风险降低相关。
方法：本研究是一项具有巢式病例对照分析的历史队列研究。利用韩国全国医疗保险索赔数据库，我们回顾性建立了2008年1月至2020年3月期间未发生心血管事件的新诊断RAO患者队列.我们将病例组定义为有心血管事件（卒中或心肌梗死）的患者，对照组定义为无性别匹配的主要结局的RAO患者。年龄,合并症,和随访持续时间（1：2入射密度采样）。进行条件逻辑回归。
结果：在13,843例新诊断为RAO的患者中，1030例患者发生心血管事件（平均随访时间为6.4±3.7年）。共有957例病例与1914例对照相匹配。在整个研究期间，服用他汀类药物的患者比例不到一半。RAO后他汀类药物治疗与心血管事件的低风险相关(调整后的OR，0.637；95%CI0.520-0.780；P<0.001）。他汀类药物暴露时间越长，心血管风险越低。
结论：在新诊断为RAO的患者中，用他汀类药物治疗，特别是长期使用，与未来心血管事件的低风险相关。
方法：本研究是一项具有巢式病例对照分析的历史队列研究。利用韩国全国医疗保险索赔数据库，我们回顾性建立了2008年1月至2020年3月期间未发生心血管事件的新诊断RAO患者队列.我们将病例组定义为有心血管事件（卒中或心肌梗死）的患者，对照组定义为无性别匹配的主要结局的RAO患者。年龄,合并症,和随访持续时间（1：2入射密度采样）。进行条件逻辑回归。
结果：在13,843例新诊断为RAO的患者中，1030例患者发生心血管事件（平均随访时间为6.4±3.7年）。共有957例病例与1914例对照相匹配。在整个研究期间，服用他汀类药物的患者比例不到一半。RAO后他汀类药物治疗与心血管事件的低风险相关(调整后的OR，0.637；95%CI0.520-0.780；P<0.001）。他汀类药物暴露时间越长，心血管风险越低。
结论：在新诊断为RAO的患者中，用他汀类药物治疗，特别是长期使用，与未来心血管事件的低风险相关。
