title: Risk of Cerebrovascular Events in Pneumoconiosis Patients: A Population-based Study, 1996-2011.
abstract: Pneumoconiosis is a parenchymal lung disease that develops through the inhalation of inorganic dust at work. Cerebrovascular and cardiovascular events are leading causes of mortality and adult disability worldwide. This retrospective cohort study investigated the association between pneumoconiosis, and cerebrovascular and cardiovascular events by using a nationwide population-based database in Taiwan. The data analyzed in this study was retrieved from the Taiwan National Health Insurance Research Database. We selected 6940 patients with pneumoconiosis from the database as our study cohort. Another 27,760 patients without pneumoconiosis were selected and matched with those with pneumoconiosis according to age and sex as the comparison cohort. We used univariate and multivariate Cox proportional-hazard regression analyses to determine the association between pneumoconiosis and the risk of cerebrovascular and cardiovascular events after adjusting for medical comorbidities. After adjustment for age, sex, and comorbidities, the patients with pneumoconiosis exhibited a significantly higher incidence of ischemic stroke (hazard ratio [HR] 1.14, 95% confidence interval [CI] 1.05-1.24) than did those without pneumoconiosis. The incidence of hemorrhagic stroke was higher, but not significant, in the pneumoconiosis patients (HR 1.20, 95% CI 0.99-1.46). No statistically significant differences were observed between the pneumoconiosis and nonpneumoconiosis groups in acute coronary syndrome (HR 1.10, 95% CI 0.95-1.26). The findings of this study reveal an association between pneumoconiosis and a higher risk of cerebrovascular events after adjustment for comorbidities. Healthcare providers should control the related risk factors for primary prevention of stroke in pneumoconiosis patients.
authors.affiliation: From the Department of Neurology, Changhua Christian Hospital, Changhua (C-SC, S-CH); Department of Life Sciences, National Chung-Hsing University (C-SC); College of Medicine, China Medical University (C-LL); Management Office for Health Data, China Medical University Hospital, Taichung (C-LL); Department of Nuclear Medicine, E-Da Hospital, I-Shou University, Kaohsiung (M-CL); Department of Nuclear Medicine and PET Center, China Medical University Hospital (C-HK); and Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University (C-HK), Taichung, Taiwan.
authors.forename: Chieh-Sen
authors.initials: CS
authors.lastname: Chuang
authors.forename: Shang-Chang
authors.initials: SC
authors.lastname: Ho
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
authors.forename: Ming-Chia
authors.initials: MC
authors.lastname: Lin
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
mesh_terms: D054058:Acute Coronary Syndrome / Q000209:etiology; D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000209:etiology*; D015331:Cohort Studies; D015897:Comorbidity; D016001:Confidence Intervals; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011009:Pneumoconiosis / Q000150:complications*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D020521:Stroke / Q000209:etiology; D013624:Taiwan / Q000453:epidemiology