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A. E. Fung, R. S. Apte, B.-A. Nguyen-Khoa, E. L. Goehring, W. Werther, J. K. Jones; Myocardial Infarction and Cerebrovascular Accident in Patients With Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2009;50(13):4423.
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To compare the incidence rates of hospitalized myocardial infarctions (MI) and cerebrovascular accidents (CVA) in subjects with diabetic macular edema (DME) to those with diabetes but no retinal diseases.
A retrospective healthcare claims database cohort study was performed in DME subjects and diabetes controls matched for age and gender. The Ingenix LabRx Database(TM) was used to identify subjects and outcomes during the study period from January 1, 2002 to December 31, 2005. International Classification of Diseases 9th revision (ICD-9) codes were used to identify DME subjects, diabetes controls, MI, CVA, and covariates. Incidence of hospitalized MI and CVA events and adjusted rate ratios were calculated. Rate ratios were adjusted for history of MI, CVA, congestive heart failure, cardiac arrhythmia, other cerebrovascular diseases, hypertension, hyperlipidemia, coronary artery disease, angina, and use of anticoagulant or antiplatelet drugs.
In 3,519 DME subjects and 10,557 diabetes controls, the event rate of MI was 1.97/100 person years (PY) in DME, and 0.69/100 PY in controls. The adjusted rate ratio for MI was 2.53 (95% CI: 1.85-3.46, P<.001) for DME vs diabetes controls. The event rate of CVA was 1.38/100 PY in DME subjects, and 0.54/100 PY in controls. The adjusted rate ratio for CVA was 1.98 (95% CI: 1.39-2.84, P<.001).
Event rates of MI or CVA were significantly higher in subjects with DME than in diabetes controls. This study provides quantitative data on the relationship between DME and cardiovascular outcomes.
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