David D Chong, Christopher M Maatouk, Jonathan Markle, Jacqueline K Shaia, Rishi P Singh, Katherine E Talcott
{"title":"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。","authors":"David D Chong, Christopher M Maatouk, Jonathan Markle, Jacqueline K Shaia, Rishi P Singh, Katherine E Talcott","doi":"10.1016/j.jcjo.2024.05.013","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Design: </strong>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.</p><p><strong>Participants: </strong>nAMD Patients with anti-VEGF injections. Controls included nAMD patients without anti-VEGF injections, non-exudative AMD patients, and patients without AMD.</p><p><strong>Methods: </strong>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 (RR<sub>1</sub>), hemorrhagic stroke (RR<sub>2</sub>), ischemic stroke (RR<sub>3</sub>), and MI (RR<sub>4</sub>) in nAMD patients receiving anti-VEGF injections were calculated.</p><p><strong>Results: </strong>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 (RR<sub>1</sub>, 0.66; 95% CI [0.53, 0.82]), (RR<sub>2</sub>, 1.00 [0.42, 2.38]), (RR<sub>3</sub>, 1.70 [0.92,3.13]), (RR<sub>4</sub>, 0.63 [0.33, 1.18]). No increased risk was found compared to non-exudative AMD patients (RR<sub>1</sub>, 0.99 [0.95, 1.03]), (RR<sub>2</sub>, 0.94 [0.83,1.07]), (RR<sub>3</sub>, 1.04 [0.96, 1.12]), (RR<sub>4</sub>, 0.99 [0.91, 1.08]). Increased risk for ACM was observed versus no-AMD patients (RR<sub>1</sub>, 1.21 [1.15, 1.27]), but no other differences were found (RR<sub>2</sub>, 0.81 [0.70, 0.93]), (RR<sub>3</sub>, 1.00 [0.92, 1.09]), (RR<sub>4</sub>, 0.986 [0.90, 1.09]).</p><p><strong>Conclusion: </strong>Anti-VEGF injections were not associated with major cardiovascular events in nAMD patients over 5 years.</p>","PeriodicalId":3,"journal":{"name":"ACS Applied Electronic Materials","volume":null,"pages":null},"PeriodicalIF":4.3000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Cardiovascular risk in anti-VEGF treatment of neovascular age-related macular degeneration.\",\"authors\":\"David D Chong, Christopher M Maatouk, Jonathan Markle, Jacqueline K Shaia, Rishi P Singh, Katherine E Talcott\",\"doi\":\"10.1016/j.jcjo.2024.05.013\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>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.</p><p><strong>Design: </strong>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.</p><p><strong>Participants: </strong>nAMD Patients with anti-VEGF injections. Controls included nAMD patients without anti-VEGF injections, non-exudative AMD patients, and patients without AMD.</p><p><strong>Methods: </strong>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 (RR<sub>1</sub>), hemorrhagic stroke (RR<sub>2</sub>), ischemic stroke (RR<sub>3</sub>), and MI (RR<sub>4</sub>) in nAMD patients receiving anti-VEGF injections were calculated.</p><p><strong>Results: </strong>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 (RR<sub>1</sub>, 0.66; 95% CI [0.53, 0.82]), (RR<sub>2</sub>, 1.00 [0.42, 2.38]), (RR<sub>3</sub>, 1.70 [0.92,3.13]), (RR<sub>4</sub>, 0.63 [0.33, 1.18]). No increased risk was found compared to non-exudative AMD patients (RR<sub>1</sub>, 0.99 [0.95, 1.03]), (RR<sub>2</sub>, 0.94 [0.83,1.07]), (RR<sub>3</sub>, 1.04 [0.96, 1.12]), (RR<sub>4</sub>, 0.99 [0.91, 1.08]). Increased risk for ACM was observed versus no-AMD patients (RR<sub>1</sub>, 1.21 [1.15, 1.27]), but no other differences were found (RR<sub>2</sub>, 0.81 [0.70, 0.93]), (RR<sub>3</sub>, 1.00 [0.92, 1.09]), (RR<sub>4</sub>, 0.986 [0.90, 1.09]).</p><p><strong>Conclusion: </strong>Anti-VEGF injections were not associated with major cardiovascular events in nAMD patients over 5 years.</p>\",\"PeriodicalId\":3,\"journal\":{\"name\":\"ACS Applied Electronic Materials\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2024-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ACS Applied Electronic Materials\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.jcjo.2024.05.013\",\"RegionNum\":3,\"RegionCategory\":\"材料科学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ENGINEERING, ELECTRICAL & ELECTRONIC\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ACS Applied Electronic Materials","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jcjo.2024.05.013","RegionNum":3,"RegionCategory":"材料科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENGINEERING, ELECTRICAL & ELECTRONIC","Score":null,"Total":0}
Cardiovascular risk in anti-VEGF treatment of neovascular age-related macular degeneration.
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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