The effect of cholecystectomy on the risk of acute myocardial infarction in patients with gallbladder stones

ABSTRACT

Objectives: To investigate the effect of cholecystectomy on the subsequent risk of acute myocardial infarction (AMI) in patients with gallbladder stones (GBS).

Methods: We used the Taiwan National Health Insurance Research Database (NHIRD) for hospitalization to conduct a retrospective nationwide population-based cohort study. The study cohort consisted of a total of 122,421 patients aged ≥20 years with cholecystectomy for GBS between 2000 and 2010. The control cohort consisted of the GBS patients without cholecystectomy and they were randomly selected by propensity score matching with the study cohort at a 1:1 ratio according to age, sex, occupation category, urbanization level, comorbidities, and year of the index date for cholecystectomy. We measured the incidence of AMI for both cohorts.

Results: The cumulative incidence of AMI was lower in GB patients with cholecystectomy than that in those without cholecystectomy (2.26 vs 3.28 per 1000 person-years, adjusted hazard ratio [aHR] = 0.65, 95% confidence interval [CI] = 0.61–0.69). Compared to those without cholecystectomy, the risk of developing AMI after cholecystectomy was 0.69 (95% CI = 0.63–0.76) for the first year, 0.69 (95% CI = 0.63–0.77) for 2–5 years, and 0.59 (95% CI = 0.53–0.66) for ≥5 years, respectively.

Conclusions: Our findings indicate cholecystectomy ameliorates the risk of AMI in patients with GBS, and the protective effect tends to increase with incremental duration of follow-up. However, it needs more studies to ascertain the protective mechanisms of cholecystectomy against AMI.

KEYWORDS:

• Cholecystectomy
• acute myocardial infarction
• gallbladder stones

Declaration of interest

The authors have nothing to disclose.

Reviewers disclosure

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

Data collection and organization: Chien-Hua Chen, Cheng-Li Lin, Chia-Hung Kao. Data analysis and interpretation: Chien-Hua Chen, Cheng-Li Lin, Chia-Hung Kao.

Manuscript writing: Chien-Hua Chen, Cheng-Li Lin, Chia-Hung Kao.

Final approval of the manuscript: Chien-Hua Chen, Cheng-Li Lin, Chia-Hung Kao.

Data sharing

The dataset used in this study is held by the Taiwan Ministry of Health and Welfare (MOHW). The Ministry of Health and Welfare must approve our application to access this data. Any researcher interested in accessing this dataset can submit an application form to the Ministry of Health and Welfare requesting access. Please contact the staff of MOHW (Email: [email protected]) for further assistance. Taiwan Ministry of Health and Welfare Address: No.488, Sec. 6, Zhongxiao E. Rd., Nangang Dist., Taipei City 115, Taiwan (R.O.C.). All relevant data are within the paper.

Additional information

Funding

This study is supported in part by Taiwan Ministry of Health and Welfare Clinical Trial Center [MOHW106-TDU-B-212-113004]; China Medical University Hospital, Academia Sinica Taiwan Biobank Stroke Biosignature Project [BM10601010036]; Taiwan Clinical Trial Consortium for Stroke [MOST 106-2321-B-039-005]; Tseng-Lien Lin Foundation, Taichung, Taiwan, Taiwan Brain Disease Foundation, Taipei, Taiwan, and Katsuzo and Kiyo Aoshima Memorial Funds, Japan. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. No additional external funding was received for this study.