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Correlation between coronary heart disease severity and subsequent chronic rhinosinusitis severity: A retrospective
Ke-Hsin Ting1,2,3, Yen-Ting Lu4,5,6, Chung-Han Hsin4,5
1Division of Cardiology, Department of Internal Medicine, Changhua Christian Hospital, Yunlin Branch, Yunlin, Taiwan.
Insights
Patients with severe coronary heart disease (CHD) treated with coronary artery bypass grafting (CABG) had a higher risk of developing chronic rhinosinusitis (CRS). This association was particularly notable in men, highlighting a link between CHD severity and CRS incidence.
Area of Science:
- Cardiology
- Otolaryngology
- Epidemiology
Background:
- Coronary heart disease (CHD) is a significant cardiovascular condition linked to various comorbidities.
- Chronic rhinosinusitis (CRS) is an inflammatory condition of the upper airways with a complex etiology.
- Understanding the relationship between systemic diseases like CHD and CRS is crucial for comprehensive patient care.
Purpose of the Study:
- To investigate the association between the severity of coronary heart disease (CHD) and the subsequent development of chronic rhinosinusitis (CRS).
- To compare the incidence of CRS and severe CRS in patients with mild CHD (percutaneous coronary intervention, PCI) versus severe CHD (coronary artery bypass graft, CABG).
Main Methods:
- Retrospective population-based cohort study utilizing Taiwan's National Health Insurance Research Database.
- Categorization of CHD severity based on treatment: mild (PCI) and severe (CABG).
- Cox proportional hazards regression analysis to determine adjusted hazard ratios (aHRs) for CRS development.
Main Results:
- A total of 31,784 patients in the CHD-PCI group and 15,892 in the CHD-CABG group were analyzed.
- The CHD-CABG group showed a significantly higher incidence of CRS compared to the CHD-PCI group (aHR: 1.196, 95% CI: 1.064-1.280).
- Incidence rates of severe CRS did not differ significantly between the groups, but subgroup analysis indicated a stronger association between CHD severity and CRS in men.
Conclusions:
- Severe CHD treated with CABG is associated with an increased incidence of subsequent CRS.
- The link between severe CHD and CRS development is more pronounced in male patients.
- Further research may explore underlying mechanisms connecting cardiovascular health and sinonasal inflammation.
Abstract:
Coronary heart disease (CHD) is associated with the development of several diseases. This retrospective population-based cohort study investigated the association between CHD severity and subsequent chronic rhinosinusitis (CRS) of varying severity. We used data from Taiwan's National Health Insurance Research Database. CHD was categorized as severe if treated using a coronary artery bypass graft (CABG) and as mild if treated with percutaneous coronary intervention (PCI). The primary outcome of this study was the development of CRS or severe CRS treated using functional endoscopic sinus surgery. Cox proportional hazards regression was used to calculate adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for CRS and severe CRS in different patient groups. We included 31,784 patients who received PCI surgery (the CHD-PCI group) and 15,892 patients who received CABG surgery (the CHD-CABG group). A total of 813 and 482 episodes of CRS occurred in the CHD-PCI and CHD-CABG groups, respectively, and 45 and 16 severe CRS events occurred in the CHD-PCI and CHD-CABG groups, respectively. Our multivariable analysis demonstrated that the incidence of CRS in the CHD-CABG group was significantly higher than that in the CHD-PCI group (aHR: 1.196, 95% CI: 1.064-1.280, P = 0.0402), but the two groups had similar incidence rates of severe CRS (aHR: 0.795, 95% CI: 0.456-1.388, P = 0.5534). Subgroup analyses revealed that the association between CHD severity and CRS development was more significant among men (P = 0.0016). In conclusion, we determined that severe CHD treated with CABG was associated with a higher incidence of subsequent CRS, and this association was more prominent among men.
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