Abstract
BackgroundA variety of chronic inflammatory diseases are linked to ischemic heart disease (IHD); however, this association is less well studied in patients with Behçet’s syndrome (BS). The primary objective of this study was to examine the impact of BS on the risk of IHD. The secondary objective was to estimate the long-term mortality risk in patients with BS.MethodsUsing a retrospective cohort design based on the Taiwan National Health Insurance Database, patients diagnosed with BS between 2000 and 2013, without prior history of IHD, were compared to non-BS individuals. The BS and non-BS cohorts were matched with a 1:2 ratio by propensity score, accounting for the following confounders: age, sex, year of index date, comorbidities, and drug exposure. Cox proportional hazard regression was used to derive the hazard ratio (HR) for IHD and mortality. The long-term survival rate was estimated using the Kaplan-Meier method.ResultsAfter propensity score matching, a total of 1554 patients newly diagnosed with BS and 3108 control subjects were identified. The incidence rate of IHD in the BS and control groups was 2.7 and 2.9 per 1000 person-years, respectively. The risk of IHD was comparable between BS and control cohorts [adjusted HR, 1.03; 95% confidence interval (CI), 0.66 to 1.62]. The 5- and 10-year survival rate of BS patients was 96.8% and 95.0%, respectively. Patients with BS exhibited a significantly higher risk of mortality than the sex- and age-matched general population (adjusted HR, 1.73; 95% CI, 1.30 to 2.32).ConclusionUnlike other chronic systemic autoimmune disorders, BS does not appear to be associated with an excess risk of IHD.
Highlights
Behçet’s syndrome (BS) is a multi-systemic autoinflammatory disorder characterized by recurrent oral and/or genital ulcerations, uvea inflammation, and vasculitis [1–3]
A mandatory National Health Insurance (NHI) program was launched in Taiwan in 1995, and over 99% of the population had been enrolled in this program until 2013
Our present results indicate that BS does not increase the risk of ischemic heart disease (IHD), as we found a similar risk in the general population
Summary
Behçet’s syndrome (BS) is a multi-systemic autoinflammatory disorder characterized by recurrent oral and/or genital ulcerations, uvea inflammation, and vasculitis [1–3]. Regarding the survival of patients with BS, some studies have been performed in the last century, mostly in Turkey [7]. The mortality risk for patients with BS was reported by a study in the United Kingdom (UK) [8]. Despite the geographical variation in the clinical presentation of BS, it is uncertain whether the long-term prognosis of BS differs across different ethnic populations. Few studies have addressed the long-term mortality risk of BS in the Chinese population at a general population level. A variety of chronic inflammatory diseases are linked to ischemic heart disease (IHD); this association is less well studied in patients with Behçet’s syndrome (BS). The primary objective of this study was to examine the impact of BS on the risk of IHD. The secondary objective was to estimate the long-term mortality risk in patients with BS
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