Abstract
This study aimed to evaluate the potential association between coronary heart disease (CHD) severity and the subsequent dry eye disease (DED) with a different severity through the use of the National Health Insurance Research Database (NHIRD) of Taiwan. A retrospective cohort study was conducted. The CHD population was further divided into a severe CHD that had received coronary artery bypass graft (CABG) surgery group and a mild CHD that had received medicine group, then matched with a 1:2 ratio, and 29,852 and 14,926 CHD patients were put into the severe CHD and mild CHD groups, respectively. The primary outcomes were the development of DED and severe DED after CHD diagnosis. The Cox proportional hazards regression was used to produce the adjusted hazard ratio (aHR) and 95% confidence interval (CI) of DED and severe DED between groups. There were 3440 and 1276 DED cases in the mild CHD and severe CHD groups, respectively. And another 37 and 48 severe CHD events were observed in the mild and severe CHD groups, respectively. The incidence of severe DED in the severe CHD group was significantly higher compared to the mild CHD group (aHR: 5.454, 95% CI: 1.551-7.180, p = 0.0001). The cumulative probabilities of DED and severe DED were significantly higher in the severe CHD group than the mild CHD group (both p < 0.0001). In the subgroup analysis, the correlation between severe CHD and DED was higher in the patients aged older than 70 years (p < 0.0001). In conclusion, severe CHD is associated with a higher incidence of severe DED with a higher cumulative incidence.