{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T03:09:52Z","timestamp":1760238592037,"version":"build-2065373602"},"reference-count":33,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2020,8,20]],"date-time":"2020-08-20T00:00:00Z","timestamp":1597881600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>This retrospective, nationwide, matched-cohort study included 4488 new-onset keratoconus (KCN) patients, \u226512 years old, recruited between 2004 and 2011 from the Taiwan National Health Insurance Research Database. The control group included 26,928 non-KCN patients selected from the Taiwan Longitudinal Health Insurance Database 2000. Information for each patient was collected and tracked from the index date until December 2013. The incidence rate of mitral valve prolapse (MVP) was 1.77 times (95% confidence interval (CI) = 1.09\u20132.88; p = 0.0206) higher in KCN patients \u226540 years old and 1.49 times (95% CI = 1.12\u20131.98; p = 0.0060) higher in female KCN patients than in controls. After using the Cox proportional hazard regression analysis to adjust for potential confounders, including hypertension, hyperlipidemia, and congestive heart failure, KCN maintained an independent risk factor, MVP being 1.77 times (adjusted hazard ratio (HR) = 1.77, 95% CI = 1.09\u20132.88) and 1.48 times (adjusted HR = 1.48, 95% CI = 1.11\u20131.97) more likely to develop in patients \u226540 years old and female patients in the study cohort, respectively. We found that KCN patients \u226540 years of age and female KCN patients have increased risks of MVP. Therefore, it is recommended that KCN patients should be alerted to MVP.<\/jats:p>","DOI":"10.3390\/ijerph17176049","type":"journal-article","created":{"date-parts":[[2020,8,20]],"date-time":"2020-08-20T09:35:31Z","timestamp":1597916131000},"page":"6049","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Risk of Mitral Valve Prolapse in Patients with Keratoconus in Taiwan: A Population-Based Cohort Study"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6247-5050","authenticated-orcid":false,"given":"Yuh-Shin","family":"Chang","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Chi Mei Medical Center, Tainan 710, Taiwan"},{"name":"Graduate Institute of Medical Sciences, College of Health Sciences, Chang Jung Christian University, Tainan 711, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming-Cheng","family":"Tai","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shih-Feng","family":"Weng","sequence":"additional","affiliation":[{"name":"Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung 807, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jhi-Joung","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Chi Mei Medical Center, Tainan 710, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sung-Huei","family":"Tseng","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Chi Mei Medical Center, Tainan 710, Taiwan"},{"name":"Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3205-7621","authenticated-orcid":false,"given":"Ren-Long","family":"Jan","sequence":"additional","affiliation":[{"name":"Graduate Institute of Medical Sciences, College of Health Sciences, Chang Jung Christian University, Tainan 711, Taiwan"},{"name":"Department of Pediatrics, Chi Mei Medical Center, Liouying, Tainan 736, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,8,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/S0039-6257(97)00119-7","article-title":"Keratoconus","volume":"42","author":"Rabinowitz","year":"1998","journal-title":"Surv. 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