June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Stroke Risk in Advance Macular Degeneration from AREDS Data Set
Author Affiliations & Notes
  • Lawrence Ulanski
    Illinois Eye and Ear Infirmary, UIC Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL
  • Thasarat Vajaranant
    Illinois Eye and Ear Infirmary, UIC Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL
  • Charlotte Joslin
    Illinois Eye and Ear Infirmary, UIC Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL
    Epidemiology and Biostatistic, University of Illinois at Chicago, Chicago, IL
  • Footnotes
    Commercial Relationships Lawrence Ulanski, Allergan (C); Thasarat Vajaranant, None; Charlotte Joslin, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 232. doi:
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      Lawrence Ulanski, Thasarat Vajaranant, Charlotte Joslin; Stroke Risk in Advance Macular Degeneration from AREDS Data Set. Invest. Ophthalmol. Vis. Sci. 2013;54(15):232.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

The AREDS dataset was analyzed to determine the relationship between AREDS category of disease and the risk of stoke to determine if there maybe a relationship between AMD category and risk for stroke.

 
Methods
 

The dbGaP Age-Related Eye Disease Study (AREDS) dataset, a longitudinal randomized clinical trial of high-dose antioxidants for prevention of age-related macular degeneration (AMD) in predominantly whites, was analyzed. AREDS (Category 1, 2, 3 and 4) was used to assess the hazard of baseline AMD status on self- reported, newly diagnosed stroke since the last study visit. The proportional hazard assumption among AMD categories was tested with Kaplan-Meier Survival Curves and the Log-Rank and Wilcoxon tests. The hazard ratio and 95% confidence interval (95% CI) for the effect of AMD on the hazard of incident stroke was estimated using multivariable Cox Proportional Hazard regression models, treating AMD as a categorical regression variable. Testing of null hypotheses and model building was conducted (SAS v9.3, Cary, NC) by comparing -2LogLikelihood (-2LL) model values among nested models (using a Chi-Square test with appropriate degrees of freedom).

 
Results
 

Subject demographics are presented in Table 1. A total of 77 analyzed incident stroke events occurred, 42 (2.0%) in women and 35 (2.2%) in men during 12.5 years of follow-up. Proportional hazard ratio testing among AMD categories indicated a constant hazard ratio with time (Log-Rank, p = 0.23; and Wilcoxon p = 0.22 tests). Multivariable Cox regression analysis results and sex-stratified results are presented in Table 2. There is noted to be a significant dose-response increase in stroke risk in men based upon AMD category. Specifically, Categories 3 & 4 were associated with increased risk of stroke. (p<0.05) This was not seen in female subjects. Women demonstrate increased risk (p<0.001) for stroke associated with hypertension and diabetes. Significantly, stroke risk was not associated with BMI/obese, antioxidant treatment category, angina, or systolic/diastolic blood pressure.

 
Conclusions
 

While the incident of stroke was low, amongst this cohort advance AMD may serve as a risk marker for stroke in men. The difference in results between men and women may be related to differences in systemic disease pathogenesis between the sexes. Sex-stratified analyses with additional datasets are necessary to confirm these results.

   
Keywords: 412 age-related macular degeneration • 464 clinical (human) or epidemiologic studies: risk factor assessment • 413 aging  
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