title: Appendectomy increased the risk of ischemic heart disease.
abstract: BACKGROUND
  Although the appendix may not be considered vital, recent studies have noted adverse health consequences after appendectomy. This study aimed to use a population-based data set to explore whether appendectomy increases the risk for subsequent ischemic heart disease (IHD) in a 3-y follow-up period.
  
  
  METHODS
  This study used data from the Longitudinal Health Insurance Database 2000 in Taiwan. The study cohort included 5413 patients who underwent appendectomies. The comparison cohort was selected by randomly recruiting 16,239 enrollees matched with the study group in terms of sex, age, hypertension, hyperlipidemia, and diabetes. Each individual was tracked for 3 y to identify whether he and/or she developed IHD during the follow-up period. Cox proportional hazard regressions were performed for analysis.
  
  
  RESULTS
  During a 3-y follow-up, 196 (3.62%) and 375 (2.31%) IHD incidents developed in the study and the comparison cohorts, respectively. For adults aged ≥18 y, experiencing an appendectomy was independently associated with a 1.54-fold increased risk of IHD during the 3 y of follow-up (95% CI = 1.29-1.84). The association persisted in further analyses stratified by age.
  
  
  CONCLUSIONS
  There is an increased risk of subsequent IHD within 3 y after appendectomy, and this underscores the need for more serious clinical decision-making in removing the appendix. Regular monitoring for IHDs is also recommended for patients who have undergone an appendectomy.
authors.affiliation: Department of Cosmetic Applications and Management, Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan; Department of Thoracic Surgery, MacKay Memorial Hospital, Taipei, Taiwan; Department and Institute of Physiology, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Chao-Hung
authors.initials: CH
authors.lastname: Chen
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Cathay General Hospital, Taipei, Taiwan.
authors.forename: Ming-Chieh
authors.initials: MC
authors.lastname: Tsai
authors.affiliation: Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
authors.forename: Herng-Ching
authors.initials: HC
authors.lastname: Lin
authors.affiliation: Department of Psychiatry, College of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Hsin-Chien
authors.initials: HC
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Cha-Ze
authors.initials: CZ
authors.lastname: Lee
authors.affiliation: Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan; School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan. Electronic address: chungshiudong@gmail.com.
authors.forename: Shiu-Dong
authors.initials: SD
authors.lastname: Chung
mesh_terms: D000328:Adult; D001062:Appendectomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012306:Risk; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
keywords: Appendectomy; Appendix; Ischemic heart disease