Cardiovascular risk in anti-VEGF treatment of neovascular age-related macular degeneration.

IF 4.3 3区材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC ACS Applied Electronic Materials Pub Date : 2024-06-01 DOI:10.1016/j.jcjo.2024.05.013

David D Chong, Christopher M Maatouk, Jonathan Markle, Jacqueline K Shaia, Rishi P Singh, Katherine E Talcott

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Abstract

Objective: Assess 5-year all-cause mortality (ACM), hemorrhagic stroke, ischemic stroke, and myocardial infarction (MI) risks in nAMD patients receiving anti-VEGF injections compared with controls.

Design: Population-based retrospective cohort study using a U.S. federated health research network, containing de-identified data of 96 million patients from 1/1/2003 to 3/6/2023.

Participants: nAMD Patients with anti-VEGF injections. Controls included nAMD patients without anti-VEGF injections, non-exudative AMD patients, and patients without AMD.

Methods: Patients were identified using nAMD ICD-10 and anti-VEGF CPT codes and matched for age, sex, and comorbidities. Five-year relative risk of ACM (RR₁), hemorrhagic stroke (RR₂), ischemic stroke (RR₃), and MI (RR₄) in nAMD patients receiving anti-VEGF injections were calculated.

Results: A total of 27,609 nAMD patients (mean diagnosis age [SD], [78.2 (10.3)]) received anti-VEGF injections; 769 nAMD patients without injections (75.8 [12.2]), 27,599 non-exudative AMD patients (78.2 [10.3]), and 21,902 no-AMD patients (76.1 [10.5]) were identified. After matching, nAMD patients receiving injections did not show increased risk versus nAMD patients without injections (RR₁, 0.66; 95% CI [0.53, 0.82]), (RR₂, 1.00 [0.42, 2.38]), (RR₃, 1.70 [0.92,3.13]), (RR₄, 0.63 [0.33, 1.18]). No increased risk was found compared to non-exudative AMD patients (RR₁, 0.99 [0.95, 1.03]), (RR₂, 0.94 [0.83,1.07]), (RR₃, 1.04 [0.96, 1.12]), (RR₄, 0.99 [0.91, 1.08]). Increased risk for ACM was observed versus no-AMD patients (RR₁, 1.21 [1.15, 1.27]), but no other differences were found (RR₂, 0.81 [0.70, 0.93]), (RR₃, 1.00 [0.92, 1.09]), (RR₄, 0.986 [0.90, 1.09]).

Conclusion: Anti-VEGF injections were not associated with major cardiovascular events in nAMD patients over 5 years.

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抗血管内皮生长因子治疗新生血管性老年黄斑变性的心血管风险。

目标：评估接受抗血管内皮生长因子注射的 nAMD 患者的 5 年全因死亡率（ACM）、出血性中风、缺血性中风和心肌梗死（MI）风险：与对照组相比，评估接受抗血管内皮生长因子注射的 nAMD 患者的 5 年全因死亡率 (ACM)、出血性中风、缺血性中风和心肌梗死 (MI) 风险：设计：基于人群的回顾性队列研究，使用美国联合健康研究网络，包含 2003 年 1 月 1 日至 2023 年 6 月 3 日期间 9600 万患者的去标识化数据。对照组包括未注射抗血管内皮生长因子的 nAMD 患者、非渗出性 AMD 患者和无 AMD 患者：使用 nAMD ICD-10 和抗血管内皮生长因子 CPT 编码识别患者，并进行年龄、性别和合并症匹配。计算接受抗血管内皮生长因子注射的 nAMD 患者发生 ACM（RR1）、出血性中风（RR2）、缺血性中风（RR3）和心肌梗死（RR4）的五年相对风险：共有 27,609 名 nAMD 患者（平均诊断年龄 [SD]，[78.2 (10.3)]）接受了抗血管内皮生长因子注射；769 名未接受注射的 nAMD 患者（75.8 [12.2]）、27,599 名非渗出性 AMD 患者（78.2 [10.3]）和 21,902 名非 AMD 患者（76.1 [10.5]）接受了抗血管内皮生长因子注射。匹配后，接受注射的非渗出性 AMD 患者与未接受注射的非渗出性 AMD 患者相比，风险未见增加（RR1，0.66；95% CI [0.53，0.82]），（RR2，1.00 [0.42，2.38]），（RR3，1.70 [0.92，3.13]），（RR4，0.63 [0.33，1.18]）。与非渗出性 AMD 患者相比，未发现风险增加（RR1，0.99 [0.95，1.03]）、（RR2，0.94 [0.83，1.07]）、（RR3，1.04 [0.96，1.12]）、（RR4，0.99 [0.91，1.08]）。与非 AMD 患者相比，观察到 ACM 风险增加（RR1，1.21 [1.15，1.27]），但未发现其他差异（RR2，0.81 [0.70，0.93]）、（RR3，1.00 [0.92，1.09]）、（RR4，0.986 [0.90，1.09]）：抗 VEGF 注射与 nAMD 患者 5 年内的主要心血管事件无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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