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Pneumoconiosis increases the risk of peripheral arterial disease: a nationwide population-based study
Chih-Hao Shen1, Te-Yu Lin, Wen-Yen Huang
1From the Division of Pulmonary and Critical Care Medicine (C-HS), Department of Internal Medicine; Division of Infectious Diseases and Tropical Medicine (T-YL), Department of Internal Medicine; Department of Radiation Oncology (W-YH), Tri-Service General Hospital, National Defense Medical Center, Taipei; Management Office for Health Data (H-JC), China Medical University Hospital; College of Medicine (H-JC), China Medical University, Taichung; Graduate Institute of Clinical Medical Science (C-HK), College of Medicine, China Medical University; and Department of Nuclear Medicine and PET Center (C-HK), China Medical University Hospital, Taichung, Taiwan.
Abstract:
This nationwide population-based retrospective cohort study was used to evaluate the association between pneumoconiosis and peripheral arterial disease (PAD). We identified 3374 patients with pneumoconiosis from the catastrophic illness registry who were newly diagnosed from 2000 to 2005; 13,496 patients without pneumoconiosis from Longitudinal Health Insurance Database 2000 (LHID2000) were randomly frequency matched according to sex, age, and index year and used as a nonpneumoconiosis group. Multivariate Cox proportional hazards regression was used to calculate adjusted hazard ratios (HRs) of PAD in the pneumoconiosis group compared with the nonpneumoconiosis group. The mean follow-up years were 7.44 years in the pneumoconiosis group and 8.17 years in the nonpneumoconiosis group. The incidence density rate of PAD was 1.25 times greater in the pneumoconiosis group than in the nonpneumoconiosis group (8.37 vs 6.70 per 1000 person-years). After adjusting for sex, age, and comorbidities, the adjusted HRs of PAD for the pneumoconiosis group were 1.30 (95% CI = 1.08-1.57), compared with the nonpneumoconiosis group. The combined impacts of patients with pneumoconiosis and diabetes, hyperlipidemia, hypertension, ischemic heart disease, chronic obstructive pulmonary disease, and asthma showed a significant by joint association with PAD risk compared with patients with no pneumoconiosis and no counterpart comorbidity. Patients with pneumoconiosis have an independently higher risk of developing PAD. Physicians should include pneumoconiosis in evaluating PAD risk.
