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Cited by 42Endometriosis Research and TreatmentInfective Endocarditis Diagnosis and ManagementEctopic Pregnancy Diagnosis and Management

Risk of major adverse cardiovascular and cerebrovascular events in Taiwanese women with endometriosis

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Chiang, Hsin-Ju, Lan, Kuo-Chung, Yang, Yao-Hsu, Chiang, John Y., Kung, Fu-Tsai, Huang, Fu-Jen, Lin, Yu-Ju, Su, Yu-Ting +1 more·2021·Journal of the Formosan Medical Association
DOI 10.1016/j.jfma.2020.10.005
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Abstract

BACKGROUND/PURPOSE: Endometriosis (EM) is linked to cardiovascular disease (CVD). However, whether this finding can be applied to the Taiwanese population remained unanswered. To investigate the association between EM and major adverse cardiovascular and cerebrovascular events (MACCE) and the therapeutic effect on the risk of MACCE in Asian women with EM. A retrospective population-based cohort study was performed. METHODS: A total of 17 543 patients with EM aged between 18 and 50 years were identified from a general population of 1 million Taiwanese after excluding diagnoses of major CVD and cerebrovascular accident (CVA) prior to EM. The comparison group (n = 70 172) without EM was selected by matching the study cohort with age, sex, and income and urbanization levels in a 4:1 ratio. RESULTS: During a median follow-up period of 9.2 years, Taiwanese women with EM had a significantly higher frequency of comorbidities, medical and surgical treatment, and MACCE than did their non-EM counterparts (2.76% vs 2.18%, P < .0001). After adjustment for comorbidities, patients with EM had an approximately 1.2-fold increased risk of MACCE (95% CI 1.05-1.29; P = .0053) and a higher cumulative incidence of MACCE compared with the normal population. Neither medical nor surgical treatment increased the risk of MACCE. Furthermore, medical treatment for EM appeared to be protective against MACCE. CONCLUSION: Taiwanese women with EM not only had a substantially higher frequency of comorbidities but also an increased risk of MACCE compared with the general population.

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  • Exclusion of women with a current prescription of GnRH analogues was not associated with attenuation of CVD risk.

    “Exclusion of women with a current prescription of GnRH analogues was not associated with attenuation of CVD risk, consistent with the results from the study by Chiang et al. 32”

    From Risk of cardiovascular outcomes among women with endometriosis in the United Kingdom: a retrospective matched cohort study (2021) · cites this paper as [32]

    The Results (page unavailable) report increased cardiovascular risk in women with endometriosis, consistent with the broader risk finding. The Definition section includes GnRH agonists among medical treatments, but the paper does not report an analysis excluding women with current GnRH prescriptions or test whether that exclusion attenuated risk. (LLM, conf=0.83)

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  • A recent population-based cohort study by Chiang et al. found an increased risk of composite CVD including cerebrovascular events among Taiwanese women with endometriosis compared with controls.

    “Our findings are supported by a recent population-based cohort study by Chiang et al., which found an increased risk of composite CVD including cerebrovascular events among Taiwanese women with endometriosis compared with controls (Figure S3). 32”

    From Risk of cardiovascular outcomes among women with endometriosis in the United Kingdom: a retrospective matched cohort study (2021) · cites this paper as [32]

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Research works printed but not linked: 1

  1. Munzel T, Sinning C, Post F, Warnholtz A, Schulz E. Patho- physiology, diagnosis and prognostic implications of endothe- lial dysfunction. Ann Med 2008;40:180e96.

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Authors
Chiang, H.-J., Lan, K.-C., Yang, Y.-H., Chiang, J. Y., Kung, F.-T., Huang, F.-J., Lin, Y.-J., Su, Y.-T., & Sung, P.-H.
Affiliations
  • Chang Gung University (TW)
  • National Sun Yat-sen University (TW)
Corresponding author
Sung, Pei-Hsun
ORCID
Venue
Journal of the Formosan Medical Association
Publisher
Elsevier BV
Published
2021-01
Volume
120
Issue
1
Pages
327-336
ISSN
0929-6646 (ISSN-L)
DOI
10.1016/j.jfma.2020.10.005
OpenAlex
W3094615877
Cited by
42
References
41
Citations by year
2026: 9 · 2025: 11 · 2024: 9 · 2023: 7 · 2022: 3 · 2021: 3
FWCI
2.86
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of the Formosan Medical Association (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Chang Gung Memorial Hospital (CLRPG6G0043)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
  • Health Sciences › Medicine › Epidemiology › Infective Endocarditis Diagnosis and Management
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
Keywords
endometriosis, major adverse cardiac and cerebrovascular events, cardiovascular risk, cerebrovascular disease, Taiwanese women, comorbidities, Asian women
MeSH terms
Adolescent, Adult, Cardiovascular Diseases, Cerebrovascular Disorders, Endometriosis, Female, Humans, Middle Aged, Retrospective Studies, Risk Factors, Cohort Studies, Young Adult

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