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Cardiovascular Risk Associated With Anti-VEGF Treatment for Neovascular AMD
TAKE-HOME MESSAGE
- An analysis of data from a large cohort of patients with neovascular age-related macular degeneration (nAMD) in the US who received intravitreal injections showed that, over a 5-year period, the risk of ischemic stroke or myocardial infarction in these patients was not different from that in controls with nAMD who had not received injections. Additionally, the risk of hemorrhagic stroke in these patients was lower than in controls without age-related macular degeneration.
- These findings are reassuring regarding the risk of major adverse cardiovascular events conferred by intravitreal injections for nAMD.
abstract
This abstract is available on the publisher's site.
Access this abstract now Full Text Available for ClinicalKey SubscribersOBJECTIVE
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.
Additional Info
Cardiovascular risk in anti-VEGF treatment of neovascular age-related macular degeneration
Can J Ophthalmol 2024 Jun 01;[EPub Ahead of Print], DD Chong, CM Maatouk, J Markle, JK Shaia, RP Singh, KE TalcottFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.