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M. Pezda, J. Gasperini, J. Law, A. G. Sharma, D. Eliott; Cardiovascular Risk in Patients Undergoing Diabetic Vitrectomy. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1400.
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To assess the risk of cardiovascular disease in patients undergoing diabetic vitrectomy for complications of proliferative diabetic retinopathy.
A retrospective chart review was conducted analyzing 350 patients who underwent diabetic vitrectomy by one vitreoretinal surgeon (DE). Medical records of these patients were reviewed from the Detroit Medical Center (affiliate of the Kresge Eye Institute) for complications of heart disease. Cardiovascular disease was assessed via data gathered from charts, discharge summaries, history and physical dictations, troponin levels, and emergency room, echocardiogram, cardiac catheterization, operative, and cardiology consultation reports. The time intervals between vitrectomy and cardiovascular complications were studied.
Hospital records were obtained of visits to the Detroit Medical Center of 350 patients who had diabetic vitrectomy. Of these patients, 43 (12%) had a confirmed diagnosis of myocardial infarction (MI). 23 of the 43 MI patients (53%) suffered MI after vitrectomy, 7 occurring within 2 years after vitrectomy. 32 of the vitrectomy patients underwent cardiac catheterization, 23 occurring after vitrectomy, 10 requiring at least one intraluminal stent to be placed, and 7 requiring percutaneous transluminal coronary angioplasty (PTCA). 24 patients underwent coronary artery bypass grafting (CABG), 11 occurring after vitrectomy, and 12 requiring more than one coronary graft. 77/350 (22%) patients also had a diagnosis of congestive heart failure (CHF) with an average ejection fraction of 31.7%. Of these patients, 51 were diagnosed after vitrectomy.
There is a significant risk of cardiovascular disease among diabetic patients that eventually undergo vitrectomy. A significant number of patients had complications of cardiovascular disease after undergoing vitrectomy. These patients developed cardiovascular complications in the forms of MI, CHF, cardiac catheterization, and CABG. Limitations of this study included reviewing records of one hospital center. Some vitrectomy patients may have developed cardiovascular complications and received care at a different hospital. Therefore, the study potentially underestimates the prevalence of cardiovascular disease in vitrectomy patients. Diabetic patients that eventually undergo vitrectomy are at significant risk of subsequently developing complications of cardiovascular disease, even without prior cardiovascular morbidity.
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