The risk of coronary heart disease after diagnosis of gallbladder polyp: a retrospective nationwide population-based cohort study

Chien-Hua Chen, Cheng-Li Lin, Chia-Hung Kao

Abstract

Background: To assess the subsequent risk of coronary heart disease (CHD) after the diagnosis of gallbladder polyp (GP).
Methods: We identified 2,815 GP patients aged ≥20 years from the Longitudinal Health Insurance Database between 2000 and 2011 and followed up the patients until the occurrence of CHD or the end of 2011, the patient would be censored in the occurrence of death, missed information, or withdrawal from the NHI. We selected 11,260 non-GP subjects by 4:1 randomly matching with the case cohort according to age, sex, and index date of GP diagnosis.
Results: GP cohort had greater risk of CHD than the control cohort [11.1 vs. 8.07 per 1,000 person-y, adjusted HR (aHR) of 1.28, 95% confidence interval (CI), 1.07–1.53] after adjusting age, sex, hypertension, diabetes, hyperlipidemia, gallstone, chronic obstructive pulmonary disease, and arrhythmia. The risk of CHD was significantly higher in the non-cholecystectomy cohort of GP patients than that in the non-GP cohort (10.9 vs. 8.07 per 1,000 person-y; aHR =1.28; 95% CI, 1.06–1.55). However, the risk of CHD contributed by GP was not significant after cholecystectomy (12.3 vs. 8.07 per 1,000 person-y; aHR =1.24; 95% CI, 0.83– 1.85). Compared with the non-GP cohort without hypertension, the risk of CHD increased for GP cohort without (aHR =1.48; 95% CI, 1.18–1.87) or with hypertension (aHR =3.00; 95% CI, 2.30–3.92). Compared with the non-GP cohort without diabetes, the risk of CHD increased for GP cohort without diabetes (aHR = 1.46; 95% CI, 1.21–1.76) or with diabetes (aHR =2.07; 95% CI, 1.35–3.18). Compared with the non-GP cohort without hyperlipidemia, the risk of CHD increased for GP cohort without (aHR =1.37; 95% CI, 1.10–1.70) or with hyperlipidemia (aHR =2.63; 95% CI, 2.01–3.44). Compared with the non-GP cohort without arrhythmia, the risk of CHD for GP patients increased without (aHR =1.40; 95% CI, 1.17–1.69) or with arrhythmia (aHR =2.88; 95% CI, 1.82–4.57).
Conclusions: GP is associated with increased risk of developing CHD, and the risk increases with the presence of coexisting hypertension, diabetes, hyperlipidemia, or arrhythmia.