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Felina Kremer, Wen-Jeng (Melissa) Yao; Effects of Topical Timolol on Cardiovascular Events in Glaucoma Patients over Forty-five Years Old. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5811. doi: https://doi.org/.
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This study aims to evaluate whether there is a difference in cardiovascualar events between glaucoma patients treated with timolol, or a combination medication, and those naïve to topical beta blockers.
Two cohorts of patients were identified using the Clinical Looking Glass (CLG) software. Patients in both cohorts were over fourty-five years old and carried the diagnosis of glaucoma in the time period between January 1st, 1994 and January 1st 2014. The first cohort was treated with timolol, Combigan, or Cosopt; while the second cohort was never treated with any topical beta-blockers. Our outcome measures included inpatient admissions for acute myocardial infarction, new onset congestive heart failure, coronary artery disease, chest pain and cardiac arrest. Statistical analysis was performed using Microsoft Office Excel 2012 and Biomedical calculator (http://www.medcalc.org).
A total of 12,668 patients were identified (5,110 in the treated and 7,558 in the untreated groups). Using data analysis, 1,935 records were identified as duplicates between the two cohorts and were therefore excluded from the study. This occurred because the patients were treated with timolol at some point in the past, but before the index date chosen for the search criteria. In the treated group, 51 patients (0.016%) were hospitalized for cardiovascular events (Odds Ratio 1.0037, CI 0.7099-1.4190, z statistic 0.021, P 0.9834) as compared to 90 patients (0.016%) in the non-treated group.
Despite the unfavorable effect on lipid profile demonstrated in some studies, topical timolol does not appear to be associated with increased incidence of cardiovascular events. Therefore, predisposition to atherosclerotic disease should not be considered a contraindication to topical beta-blockers.
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