Chien-Hua Chen1,2,3, Cheng-Li Lin4,5, Yu-Shu Cheng6, Long-Bin Jeng7,8. 1. DigestiveDisease Center, Show-Chwan Memorial Hospital, Changhua, Taiwan. 2. Department of Food Science and Technology, Hungkuang University, Taichung, Taiwan. 3. Chung Chou University of Food Science and Technology, Yuanlin Township, Changhua County, Taiwan. 4. Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan. 5. College of Medicine, China Medical University, Taichung, Taiwan. 6. Department of Surgery, Division of Bariatric Surgery, China Medical University, Taichung, Taiwan. 7. Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung, 404, Taiwan. otc.Jeng@gmail.com. 8. Department of Surgery, Organ Transplantation Center, China Medical University Hospital, Taichung, Taiwan. otc.Jeng@gmail.com.
Abstract
BACKGROUND: We assessed the risk of coronary heart disease (CHD) after subtotal gastrectomy with Billroth II anastomosis (SGBIIA) for peptic ulcer disease (PUD). METHODS: The Taiwan National Health Insurance Research Database was used, and 6160 patients undergoing SGBIIA for PUD were identified as the surgical cohort. A total of 24,540 patients from the PUD population not undergoing surgery selected by frequency-matching were identified as the non-surgical cohort. All patients were followed until the end of 2011 to measure the incidence of CHD. RESULTS: The cumulative incidence of CHD was lower in patients with SGBIIA than in those without surgery (16.9 vs 22.9 per 1000 person-year, adjusted hazard ratio [aHR] = 0.79, 95% confidence interval [CI] = 0.71-0.88). The risk of CHD, either acute coronary syndrome (ACS) (aHR = 0.83, 95% CI = 0.75-0.91) or other non-ACS CHD (aHR = 0.78, 95% CI = 0.68-0.88), was lower for the SGBIIA cohort than for the non-surgery cohort (aHR = 0.79, 95% CI = 0.71-0.88) after adjusting for age and the comorbidities of hypertension, diabetes mellitus, hyperlipidemia, stroke, congestive heart failure, chronic kidney disease, and chronic obstructive pulmonary disease. CONCLUSIONS: We found SGBIIA is associated with a reduced risk of CHD for PUD patients.
BACKGROUND: We assessed the risk of coronary heart disease (CHD) after subtotal gastrectomy with Billroth II anastomosis (SGBIIA) for peptic ulcer disease (PUD). METHODS: The Taiwan National Health Insurance Research Database was used, and 6160 patients undergoing SGBIIA for PUD were identified as the surgical cohort. A total of 24,540 patients from the PUD population not undergoing surgery selected by frequency-matching were identified as the non-surgical cohort. All patients were followed until the end of 2011 to measure the incidence of CHD. RESULTS: The cumulative incidence of CHD was lower in patients with SGBIIA than in those without surgery (16.9 vs 22.9 per 1000 person-year, adjusted hazard ratio [aHR] = 0.79, 95% confidence interval [CI] = 0.71-0.88). The risk of CHD, either acute coronary syndrome (ACS) (aHR = 0.83, 95% CI = 0.75-0.91) or other non-ACS CHD (aHR = 0.78, 95% CI = 0.68-0.88), was lower for the SGBIIA cohort than for the non-surgery cohort (aHR = 0.79, 95% CI = 0.71-0.88) after adjusting for age and the comorbidities of hypertension, diabetes mellitus, hyperlipidemia, stroke, congestive heart failure, chronic kidney disease, and chronic obstructive pulmonary disease. CONCLUSIONS: We found SGBIIA is associated with a reduced risk of CHD for PUD patients.
Entities:
Keywords:
Coronary heart disease; Peptic ulcer disease; Roux-en-Y gastric bypass surgery; Subtotal gastrectomy with Billroth II anastomosis
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