Association between Statins and Retinal Vascular Occlusion: A Population-Based Cohort Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Sources
2.2. Inclusion and Exclusion Criteria
2.3. Study Variables
2.4. Study Outcome
2.5. Statistical Analysis
3. Results
3.1. Demographic Characteristics of the Study Sample
3.2. Cumulative Hazard Curves by the Kaplan–Meier Method
3.3. Univariate and Multivariate Analyses by the Cox Regression Model
3.4. Subgroup Analysis
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Statin | With | Without | p | ||
---|---|---|---|---|---|
Variables | n | % | n | % | |
Total | 32,025 | 25.00 | 96,075 | 75.00 | |
Gender | 0.999 | ||||
Male | 15,096 | 47.14 | 45,288 | 47.14 | |
Female | 16,929 | 52.86 | 50,787 | 52.86 | |
Age (years) | 54.57 ± 13.51 | 52.34 ± 16.51 | 0.088 | ||
DM | <0.001 * | ||||
Without | 23,513 | 73.42 | 87,195 | 90.76 | |
With | 8512 | 26.58 | 8880 | 9.24 | |
HTN | <0.001 * | ||||
Without | 23,600 | 73.69 | 85,693 | 89.19 | |
With | 8425 | 26.31 | 10,382 | 10.81 | |
Hyperlipidemia | <0.001 * | ||||
Without | 7027 | 21.94 | 95,078 | 98.96 | |
With | 24,998 | 78.06 | 997 | 1.04 | |
IHD | <0.001 * | ||||
Without | 29,513 | 92.16 | 91,352 | 95.08 | |
With | 2512 | 7.84 | 4723 | 4.92 | |
CVD | <0.001 * | ||||
Without | 28,939 | 90.36 | 90,548 | 94.25 | |
With | 3086 | 9.64 | 5527 | 5.75 | |
Renal disease | <0.001 * | ||||
Without | 29,180 | 91.12 | 94,770 | 98.64 | |
With | 2845 | 8.88 | 1305 | 1.36 | |
Tumor | <0.001 * | ||||
Without | 31,019 | 96.86 | 94,077 | 97.92 | |
With | 1006 | 3.14 | 1998 | 2.08 | |
MetS | <0.001 * | ||||
Without | 29,671 | 92.65 | 93,333 | 97.15 | |
With | 2354 | 7.35 | 2742 | 2.85 | |
Hypercoagulable state | 0.004 * | ||||
Without | 31,639 | 98.79 | 95,104 | 98.99 | |
With | 386 | 1.21 | 971 | 1.01 | |
Ischemic stroke | <0.001 * | ||||
Without | 29,040 | 90.68 | 90,623 | 94.33 | |
With | 2985 | 9.32 | 5452 | 5.67 | |
Cataract | <0.001 * | ||||
Without | 30,710 | 95.89 | 92,749 | 96.54 | |
With | 1315 | 4.11 | 3326 | 3.46 | |
Glaucoma | <0.001 * | ||||
Without | 29,240 | 91.30 | 89,064 | 92.70 | |
With | 2785 | 8.70 | 7011 | 7.30 | |
Diabetic retinopathy | <0.001 * | ||||
Without | 31,243 | 97.56 | 95,084 | 98.97 | |
With | 782 | 2.44 | 991 | 1.03 | |
AMD | <0.001 * | ||||
Without | 31,379 | 97.98 | 94,931 | 98.81 | |
With | 646 | 2.02 | 1144 | 1.19 | |
CCI | 0.05 ± 0.18 | 0.03 ± 0.15 | <0.001 * |
Variables | Crude HR | 95% CI | 95% CI | p | Adjusted HR | 95% CI | 95% CI | p |
---|---|---|---|---|---|---|---|---|
Statin | ||||||||
Without | Reference | Reference | ||||||
With | 0.792 | 0.650 | 0.965 | 0.020 * | 0.704 | 0.591 | 0.873 | <0.001 * |
Gender | ||||||||
Male | 0.953 | 0.812 | 1.118 | 0.552 | 0.970 | 0.822 | 1.111 | 0.703 |
Female | Reference | Reference | ||||||
Age (yrs) | 1.037 | 1.031 | 1.042 | <0.001 * | 1.026 | 1.019 | 1.031 | <0.001 * |
DM | ||||||||
Without | Reference | Reference | ||||||
With | 1.798 | 1.546 | 1.986 | <0.001 * | 1.714 | 1.512 | 1.888 | <0.001 * |
HTN | ||||||||
Without | Reference | Reference | ||||||
With | 2.068 | 1.573 | 2.676 | <0.001 * | 1.976 | 1.501 | 2.630 | <0.001 * |
Hyperlipidemia | ||||||||
Without | Reference | Reference | ||||||
With | 1.234 | 1.004 | 1.308 | 0.046 * | 0.819 | 0.478 | 1.335 | 0.586 |
IHD | ||||||||
Without | Reference | Reference | ||||||
With | 1.462 | 1.297 | 1.682 | <0.001 * | 1.369 | 1.194 | 1.617 | <0.001 * |
CVD | ||||||||
Without | Reference | Reference | ||||||
With | 1.350 | 1.104 | 1.553 | <0.001 * | 1.271 | 1.043 | 1.495 | 0.007 * |
Renal disease | ||||||||
Without | Reference | Reference | ||||||
With | 1.668 | 1.321 | 2.095 | <0.001 * | 1.609 | 1.225 | 1.962 | <0.001 * |
Tumor | ||||||||
Without | Reference | Reference | ||||||
With | 1.032 | 0.862 | 1.345 | 0.184 | 1.031 | 0.860 | 1.352 | 0.176 |
MetS | ||||||||
Without | Reference | Reference | ||||||
With | 2.065 | 1.482 | 2.798 | <0.001 * | 1.531 | 1.045 | 2.088 | 0.003 * |
Hypercoagulable state | ||||||||
Without | Reference | Reference | ||||||
With | 1.526 | 0.862 | 2.060 | 0.289 | 1.306 | 0.671 | 1.884 | 0.462 |
Ischemic stroke | ||||||||
Without | Reference | Reference | ||||||
With | 1.398 | 1.167 | 1.592 | <0.001 * | 1.288 | 1.050 | 1.516 | 0.001 * |
Cataract | ||||||||
Without | Reference | Reference | ||||||
With | 1.411 | 1.086 | 1.702 | 0.004 * | 1.352 | 1.015 | 1.670 | 0.032 * |
Glaucoma | ||||||||
Without | Reference | Reference | ||||||
With | 1.525 | 1.126 | 1.978 | <0.001 * | 1.488 | 1.034 | 1.826 | 0.018 * |
Diabetic retinopathy | ||||||||
Without | Reference | Reference | ||||||
With | 1.279 | 1.089 | 1.465 | <0.001 * | 1.186 | 1.003 | 1.395 | 0.046 * |
AMD | ||||||||
Without | Reference | Reference | ||||||
With | 1.382 | 0.979 | 1.891 | 0.072 | 1.297 | 0.875 | 1.742 | 0.088 |
CCI_R | 1.234 | 1.125 | 1.290 | <0.001 * | 1.200 | 1.093 | 1.248 | <0.001 * |
Statin | With | Without (Reference) | With vs. Without (Reference) | |||||||
---|---|---|---|---|---|---|---|---|---|---|
Retinal Vascular Occlusion Subgroups | Events | PYs | Rate (per 105 PYs) | Events | PYs | Rate (per 105 PYs) | Adjusted HR | 95% CI | 95% CI | p |
Overall | 124 | 413,862.59 | 29.96 | 486 | 1,235,055.74 | 39.35 | 0.704 | 0.591 | 0.873 | <0.001 * |
Central Retinal Artery Occlusion | 31 | 413,862.59 | 7.49 | 126 | 1,235,055.74 | 10.20 | 0.679 | 0.564 | 0.841 | <0.001 * |
Arterial Branch Occlusion | 27 | 413,862.59 | 6.52 | 119 | 1,235,055.74 | 9.64 | 0.620 | 0.518 | 0.779 | <0.001 * |
Central Retinal Vein Occlusion | 34 | 413,862.59 | 8.22 | 124 | 1,235,055.74 | 10.04 | 0.758 | 0.640 | 0.952 | 0.008 * |
Branch Retinal Vein Occlusion | 32 | 413,862.59 | 7.73 | 117 | 1,235,055.74 | 9.47 | 0.743 | 0.629 | 0.939 | <0.001 * |
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Chien, C.-C.; Chen, P.-H.; Chung, C.-H.; Sun, C.-A.; Chien, W.-C.; Chien, K.-H. Association between Statins and Retinal Vascular Occlusion: A Population-Based Cohort Study. Int. J. Environ. Res. Public Health 2021, 18, 9864. https://doi.org/10.3390/ijerph18189864
Chien C-C, Chen P-H, Chung C-H, Sun C-A, Chien W-C, Chien K-H. Association between Statins and Retinal Vascular Occlusion: A Population-Based Cohort Study. International Journal of Environmental Research and Public Health. 2021; 18(18):9864. https://doi.org/10.3390/ijerph18189864
Chicago/Turabian StyleChien, Chien-Cheng, Po-Huang Chen, Chi-Hsiang Chung, Chien-An Sun, Wu-Chien Chien, and Ke-Hung Chien. 2021. "Association between Statins and Retinal Vascular Occlusion: A Population-Based Cohort Study" International Journal of Environmental Research and Public Health 18, no. 18: 9864. https://doi.org/10.3390/ijerph18189864