The purpose of the study was to address the association between hemorrhoid and the subsequent risk of coronary heart disease (CHD) development. This retrospective cohort study used reimbursement claims data from the Longitudinal Health Insurance Database 2000 in Taiwan. Thirty-three thousand thirty-four patients with hemorrhoids and 132,136 age-, gender-, and index year matched controls between 2000 and 2010 were identified. Cox model was performed to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of CHD development for the hemorrhoid cohort compared with the nonhemorrhoid cohort. During a follow-up period of 12 years, the overall incidence rate of CHD was 9.91 per 1000 person-years in the hemorrhoid patients and was 1.36-fold higher than in the nonhemorrhoid cohort (7.28 per 1000 person-years) with an adjusted hazard ratio (aHR) of 1.27 (95% CI = 1.21–1.34). Moreover, compared with the nonhemorrhoid patients without these comorbidities, among patients with hemorrhoids, those with any 2 comorbidities were at a significantly increased risk of CHD (HR = 7.12, 95% CI = 6.61–7.67; P < .001), followed by those with any 1 comorbidity (HR = 3.23, 95% CI = 2.94–3.54; P < .001). We found that hemorrhoid patients had a 1.27-fold higher risk of CHD compared with those without hemorrhoids after adjusting for the potential confounding factors.

We conducted this nationwide cohort study to identify the performance of CHA₂DS₂-VASc score for ischaemic stroke risk stratification in chronic obstructive pulmonary disease (COPD) patients whether they had comorbid atrial fibrillation (AF) or not. Using the longitudinal health insurance database 2000, patients aged ≥20 years with newly diagnosed COPD from 2000 to 2011 with at least three claims for outpatient and/or hospitalization visits were identified. A total of 1492 COPD patients with AF and 50 343 COPD patients without AF were included in this study. We calculated the CHA₂DS₂-VASc score—specific incidence density rates of ischaemic stroke with person-years in each cohort. Cox models were conducted to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of ischaemic stroke risk in COPD patients with and without concomitant AF. The predictive performance of CHA₂DS₂-VASc score with regard to ischaemic stroke events was assessed using area under the receiver operating characteristic curve (C-statistic). COPD patients with a higher CHA₂DS₂-VASc score were more likely to develop ischaemic stroke whether or not AF was present. Moreover, the C-statistics of CHA₂DS₂-VASc score in predicting ischaemic stroke in COPD patients with and without AF were 0.58 (95% CI = 0.55–0.62) and 0.71(95% CI = 0.70–0.72), respectively. Our study is the first to show that the performance of CHA₂DS₂-VASc score in predicting ischaemic stroke is better for COPD patients without AF than for COPD patients with AF.