Significantly increased risk of cardiovascular disease among patients with gallstone disease: a population-based cohort study

PLoS One. 2013 Oct 3;8(10):e76448. doi: 10.1371/journal.pone.0076448. eCollection 2013.

Abstract

Objective: To investigate whether gallstone disease (GD) increases the risk of developing cardiovascular disease (CVD) in a large population-based cohort.

Methods: A study population including 6,981 patients with GD was identified from The Taiwan National Health Insurance Research Database between 2004 and 2005. GD patients were defined as patients with principal discharge diagnoses of cholelithiasis using the ICD-9-CM code 574. 27,924 patients without GD were randomly selected and matched for age and gender. All patients were followed for 6 years or until diagnosis for CVD. Cox proportional hazards regression model was used to assess the risk of developing CVD with adjustment for age, gender and co-morbid conditions.

Results: During the six years follow-up period, 935 patients with GD and 2,758 patients without GD developed CVD. Patients with GD had an elevated risk of CVD (HR, 1.32; 95% CI, 1.22-1.43) when compared with those without GD. Similar relationship was observed when CVD was categorized i.e. stroke (HR, 1.15; 95% CI, 1.01-1.32), coronary heart disease (HR, 1.42; 95% CI, 1.28-1.58) and heart failure (HR, 1.31; 95% CI, 1.00-1.73). When GD was classified according to the level of severity, using patients without GD as reference, the risks of CVD were elevated in patients with non-severe GD (HR, 1.34; 95% CI, 1.24-1.46) as well as those with severe GD (HR, 1.20, 95% CI, 1.02-1.40), after adjusting for age, gender and comorbidities. In age-stratified analysis, patients aged 18-40 years with GD were at higher risk of developing CVD (HR, 1.42; 95% CI, 1.09-1.84) than older GD patients.

Conclusion: This study found an increased risk of CVD in patients diagnosed with GD. The excess risk was particularly high in younger GD patients. Prevention of GD could help reduce the risk of developing CVD, and the better effect could be achieved for the younger age groups.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / etiology*
  • Cohort Studies
  • Comorbidity
  • Databases, Factual
  • Female
  • Gallstones / complications*
  • Gallstones / epidemiology*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Population Surveillance
  • Risk*
  • Taiwan / epidemiology
  • Young Adult

Grant support

This study was supported by grants from the National Science Council of Taiwan (NSC99-2314-B-038-022-MY3, NSC00-2314-B-038-030-My3, NSC100-2314-B-038-031-My3), Taipei Medical University (TMU99-AE1-B07), the Department of Health Center of Excellence for Clinical Trial and Research in Neuroscience (DOH101-TD-B-111-003, DOH102-TD-B-111-003), and Dr. Chi-Chin Huang Stroke Research Center. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.