Hospitalized cardiovascular diseases in neovascular age-related macular degeneration
Hospitalized cardiovascular diseases in neovascular age-related macular degeneration
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DOI：
10.1001/archopht.126.9.1280
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发表时间：
2008-09-01
影响因子：
--
通讯作者：
Jones, Judith K.
中科院分区：
文献类型：
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作者：
Nguyen-Khoa, Bao-Anh;Goehring, Earl L., Jr.;Jones, Judith K.
目标：比较有和没有新生血管性年龄相关性黄斑变性（AMD）的受试者住院心肌梗死（MI）和脑血管意外（CVA）的发生率：在年龄、性别、地理和入组时间匹配的新生血管性AMD受试者和对照组中进行回顾性数据库队列研究。从2002年1月1日至2005年6月30日研究期间的医疗保健索赔用于确定受试者和结局。住院MI和CVA事件的发生率和率比调整为11个危险factors.Results：在7203例新生血管性AMD和20 208对照组，MI的发生率为16.2事件每1000例新生血管性AMD和23.1事件每1000对照组。新生血管性AMD受试者与对照组的MI校正率比为0.58（95%置信区间，0.48-0.72; P <0.001）。CVA的发生率为每1000例新生血管性AMD受试者14.3起事件，每1000例对照者22.1起事件。CVA的校正率比为0.56（95%可信区间为0.45-0.70; P <0.01）。结论：新生血管性AMD患者的MI或CVA发生率显著低于对照组。这些发现不能用病例选择、医疗保健使用或合并症的系统性差异来解释，尽管不能排除其他可能的偏倚。
Objective: To compare the incidence rate of hospitalized myocardial infarctions (MIs) and cerebrovascular accidents (CVAs) in subjects with and without neovascular age-related macular degeneration (AMD).Methods: A retrospective database cohort study was performed in subjects with neovascular AMD and controls matched for age, sex, geography, and enrollment duration. Healthcare claims for the study period from January 1, 2002, to June 30, 2005, were used to identify subjects and outcomes. Incidence of hospitalized MI and CVA events and rate ratios adjusted for 11 risk factors were calculated.Results: In 7203 subjects with neovascular AMD and 20 208 controls, the rate of MI was 16.2 events per 1000 subjects with neovascular AMD and 23.1 events per 1000 controls. The adjusted rate ratio for MI was 0.58 ( 95% confidence interval, 0.48-0.72; P < .001) for subjects with neovascular AMD vs controls. The rate of CVA was 14.3 events per 1000 subjects with neovascular AMD and 22.1 events per 1000 controls. The adjusted rate ratio for CVA was 0.56 (95% confidence interval, 0.45-0.70; P < . 001).Conclusions: Rates of MI or CVA were significantly lower in subjects with neovascular AMD than in controls. These findings could not be explained by systematic differences in case selection, health care use, or comorbidities, although other possible biases cannot be ruled out.