June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Risk of myocardial infarction following diagnosis of a common ophthalmic disease: analysis of a longitudinal record-linkage study of over 350,000 patients from the UK.
Author Affiliations & Notes
  • Siegfried Wagner
    Institute of Ophthalmology, University College London, London, London, United Kingdom
    Moorfields Eye Hospital NHS Foundation Trust, London, London, United Kingdom
  • Mario Cortina-Borja
    Institute of Child Health, University College London, London, London, United Kingdom
  • Alastair K Denniston
    University of Birmingham, Birmingham, Birmingham, United Kingdom
    University Hospitals Birmingham NHS Foundation Trust, Birmingham, Birmingham, United Kingdom
  • Fintan Hughes
    Duke University Hospital, Durham, North Carolina, United States
  • Nikolas Pontikos
    Institute of Ophthalmology, University College London, London, London, United Kingdom
    Moorfields Eye Hospital NHS Foundation Trust, London, London, United Kingdom
  • Jugnoo Rahi
    Institute of Child Health, University College London, London, London, United Kingdom
    Great Ormond Street Hospital for Children NHS Foundation Trust, London, London, United Kingdom
  • Pearse Keane
    NIHR Biomedical Research Centre at University College London and Moorfields Eye Hospital NHS Foundation Trust, University College London, London, London, United Kingdom
  • Footnotes
    Commercial Relationships   Siegfried Wagner, None; Mario Cortina-Borja, None; Alastair Denniston, None; Fintan Hughes, None; Nikolas Pontikos, Phenopolis (E); Jugnoo Rahi, None; Pearse Keane, Allergan (F), Apellis (C), Bayer (F), Big Picture Medical (I), DeepMind (C), Heidelberg Engineering (F), Novartis (F), Roche (F), Topcon (F)
  • Footnotes
    Support  MRC Clinical Research Training Fellowship; Fight for Sight Small Grant Award
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 75. doi:
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      Siegfried Wagner, Mario Cortina-Borja, Alastair K Denniston, Fintan Hughes, Nikolas Pontikos, Jugnoo Rahi, Pearse Keane; Risk of myocardial infarction following diagnosis of a common ophthalmic disease: analysis of a longitudinal record-linkage study of over 350,000 patients from the UK.. Invest. Ophthalmol. Vis. Sci. 2021;62(8):75.

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

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Abstract

Purpose : To characterize the incidence rate of myocardial infarction (MI) in patients following a new diagnosis of cataract, glaucoma, neovascular age-related macular degeneration (AMD) or proliferative diabetic retinopathy (PDR).

Methods : A retrospective cohort study of all patients aged ≥ 40 years attending a large ophthalmic hospital of ten separate sites across London, United Kingdom linked with secondary care Hospital Episodes Statistics Admissions data between January 1st 2008 and June 1st 2018. Myocardial infarction (MI) was defined by diagnostic code I21 or I22 using the International Classification of Diseases, 10th revision and ophthalmic disease through the local electronic health record system. Crude MI incidence rates and those stratified by age, sex, ethnicity and socioeconomic deprivation (through the Index of Multiple Deprivation 2015) per ophthalmic disease were estimated with 95% Poisson intervals. Adjusted cause-specific and subdistribution hazard ratios (HR) were estimated from Cox proportional hazard and Fine-Gray competing risks regression models respectively.

Results : Of 353,191 patients, 59102 had cataract, 31060 glaucoma, 7262 AMD and 2494 PDR. Crude MI incidence rates were 494.6 (461.2-529.5), 297.7 (270.7-326.5), 528.5 (451.4-613.8) and 1449.8 (1173.3-1766.5) per 100,000 person-years at risk (PYAR) for cataract, glaucoma, AMD and PDR respectively. Patients with PDR had the highest incidence rate of MI across all strata. Incidence of MI rose sharply in young patients with cataract from 35.3 (5.0-108.8) for those aged 40-49 years to 368.8 (288.0-463.6) for those aged 50-59 years per 100,000 PYAR with a corresponding HR of 1.54 (1.43-1.66) per decade of age. Those of Asian ethnicity had increased hazards of MI following cataract diagnosis (cause-specific HR 2.67, 1.98-3.61), glaucoma (2.40, 1.69-3.40) and PDR (3.32, 1.41-7.84). Less deprivation was significantly associated with slightly reduced incidence of MI for those with cataract (HR 0.95, 0.92-0.97 per decile) and AMD (0.92, 0.87-0.97).

Conclusions : In accordance with the cardiovascular consequences of diabetes mellitus, MI incidence rate among patients with newly diagnosed PDR was highest. However, a particularly steep rise was noted in younger patients newly diagnosed with cataract supporting a role for cardiovascular risk-stratification in this group.

This is a 2021 ARVO Annual Meeting abstract.

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