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Research article
Pei-Hsun Sung
Chang Gung Memorial Hospital Kaohsiung Branch
Corresponding Author
ORCiD: https://orcid.org/0000-0002-1989-9752
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Endometriosis (EM) is linked to cardiovascular disease (CVD). However, whether this finding can be applied to the Asian population remained unanswered. Results are still conflicting in terms of therapeutic effect on the risk of CVD in patients with EM. Therefore, we investigated the association between EM and major adverse cardiovascular and cerebrovascular events (MACCE) and the therapeutic effect on the risk of MACCE in Asian women with EM.
Methods: The Taiwan National Health Insurance Research Database was used for this retrospective population-based cohort study from 1997 to 2013. A total of 17 543 patients with EM aged between 18 and 50 years were identified from a general population of 1 million after excluding diagnoses of major CVD and cerebrovascular accident (CVA) prior to EM. The comparison group (n = 70 172) without EM was selected by matching the study cohort with age, sex, and income and urbanization levels in a 4:1 ratio. Demographic data and the frequency of comorbidities between groups were compared using the independent t test and chi-square test. The incidence and risk of MACCE were analyzed using the log-rank test and a multivariate Cox proportional hazards model.
Results: During a median follow-up period of 9.2 years, Asian women with EM had a significantly higher frequency of comorbidities, medical and surgical treatment, and MACCE than did their non-EM counterparts (2.76% vs 2.18%, P < .0001). After adjustment for comorbidities, patients with EM had an approximately 1.2-fold increased risk of MACCE (95% CI 1.05-1.29; P = .0053) and a higher cumulative incidence of MACCE compared with the normal population. Among women with EM, neither medical nor surgical treatment increased the risk of MACCE, including major CVD and CVA. Furthermore, medical treatment for EM appeared to be protective against MACCE.
Conclusion: Asian women with EM not only had a substantially higher frequency of comorbidities but also an increased risk of MACCE compared with the general population. In terms of medical or surgical treatment of EM, the safety concern regarding MACCE was not evident.
Keywords
Endometriosis, Major adverse cardiovascular and cerebrovascular events, Population-based cohort study, Medical and surgical treatment
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A new preprint design is coming!
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This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research article
Pei-Hsun Sung
Chang Gung Memorial Hospital Kaohsiung Branch
Corresponding Author
ORCiD: https://orcid.org/0000-0002-1989-9752
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
The most recent version of this article is available here.
No community comments so far
Version 1
Posted 09 Oct, 2019
No comments provided
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Preventive Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
The most recent version of this article is available here.
Background: Endometriosis (EM) is linked to cardiovascular disease (CVD). However, whether this finding can be applied to the Asian population remained unanswered. Results are still conflicting in terms of therapeutic effect on the risk of CVD in patients with EM. Therefore, we investigated the association between EM and major adverse cardiovascular and cerebrovascular events (MACCE) and the therapeutic effect on the risk of MACCE in Asian women with EM.
Methods: The Taiwan National Health Insurance Research Database was used for this retrospective population-based cohort study from 1997 to 2013. A total of 17 543 patients with EM aged between 18 and 50 years were identified from a general population of 1 million after excluding diagnoses of major CVD and cerebrovascular accident (CVA) prior to EM. The comparison group (n = 70 172) without EM was selected by matching the study cohort with age, sex, and income and urbanization levels in a 4:1 ratio. Demographic data and the frequency of comorbidities between groups were compared using the independent t test and chi-square test. The incidence and risk of MACCE were analyzed using the log-rank test and a multivariate Cox proportional hazards model.
Results: During a median follow-up period of 9.2 years, Asian women with EM had a significantly higher frequency of comorbidities, medical and surgical treatment, and MACCE than did their non-EM counterparts (2.76% vs 2.18%, P < .0001). After adjustment for comorbidities, patients with EM had an approximately 1.2-fold increased risk of MACCE (95% CI 1.05-1.29; P = .0053) and a higher cumulative incidence of MACCE compared with the normal population. Among women with EM, neither medical nor surgical treatment increased the risk of MACCE, including major CVD and CVA. Furthermore, medical treatment for EM appeared to be protective against MACCE.
Conclusion: Asian women with EM not only had a substantially higher frequency of comorbidities but also an increased risk of MACCE compared with the general population. In terms of medical or surgical treatment of EM, the safety concern regarding MACCE was not evident.
Figure 1
Figure 2
Figure 3
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