Document Detail

Risks of mortality, myocardial infarction, bleeding, and stroke associated with therapies for age-related macular degeneration.
MedLine Citation:
PMID:  20937996     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To examine associations between therapies for age-related macular degeneration and risks of all-cause mortality, incident myocardial infarction, bleeding, and incident stroke.
METHODS: We conducted a retrospective cohort study of 146,942 Medicare beneficiaries 65 years or older with a claim for age-related macular degeneration between January 1, 2005, and December 31, 2006. On the basis of claims for the initial treatment, we assigned beneficiaries to 1 of 4 groups. The active control group included patients who received photodynamic therapy. The other groups included patients who received intravitreous pegaptanib octasodium, bevacizumab, or ranibizumab. We censored data from patients when they received a therapy different from the initial therapy. The main outcome measures were associations between photodynamic, pegaptanib, bevacizumab, and ranibizumab therapies and the risks of all-cause mortality, incident myocardial infarction, bleeding, and incident stroke.
RESULTS: After adjustment for baseline characteristics and comorbid conditions, we found significant differences in the rates of mortality and myocardial infarction by treatment group. Specifically, the hazard of mortality was significantly lower with ranibizumab therapy than with photodynamic therapy (hazard ratio, 0.85; 99% confidence interval, 0.75-0.95) or pegaptanib use (0.84; 0.74-0.95), and the hazard of myocardial infarction was significantly lower with ranibizumab use than with photodynamic therapy (0.73; 0.58-0.92). There were no significant differences in the hazard of mortality or myocardial infarction between bevacizumab use and the other therapies. We found no statistically significant relationship between treatment group and bleeding events or stroke.
CONCLUSION: Bevacizumab and ranibizumab use was not associated with increased risks of mortality, myocardial infarction, bleeding, or stroke compared with photodynamic therapy or pegaptanib use.
Lesley H Curtis; Bradley G Hammill; Kevin A Schulman; Scott W Cousins
Related Documents :
2882626 - High-dose acetylsalicylic acid after cerebral infarction. a swedish cooperative study.
15499036 - Extent and distribution of white matter hyperintensities in stroke patients: the sydney...
11922696 - Ischaemic brain oedema.
9492896 - Long and short axis dimensions of the left ventricle change in opposite ways during res...
9047046 - Brief repetitive ischemia: effect on norepinephrine release, arrhythmias, and functiona...
17447136 - Therapeutic and diagnostic role of electrical devices in acute heart failure.
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of ophthalmology     Volume:  128     ISSN:  1538-3601     ISO Abbreviation:  Arch. Ophthalmol.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-12     Completed Date:  2010-10-27     Revised Date:  2012-09-14    
Medline Journal Info:
Nlm Unique ID:  7706534     Medline TA:  Arch Ophthalmol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1273-9     Citation Subset:  AIM; IM    
Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina 27715, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Aged, 80 and over
Angiogenesis Inhibitors / therapeutic use*
Cause of Death
Databases, Factual
Hemorrhage / etiology,  mortality*
Macular Degeneration / drug therapy*,  mortality*
Medicare / statistics & numerical data
Myocardial Infarction / etiology,  mortality*
Proportional Hazards Models
Retrospective Studies
Risk Factors
Stroke / etiology,  mortality*
United States / epidemiology
Vascular Endothelial Growth Factor A / antagonists & inhibitors
Reg. No./Substance:
0/Angiogenesis Inhibitors; 0/Vascular Endothelial Growth Factor A
Comment In:
Arch Ophthalmol. 2012 Jan;130(1):124-5; author reply 125-6   [PMID:  22232487 ]
Arch Ophthalmol. 2012 Jun;130(6):806-7; author reply 807   [PMID:  22801854 ]
Erratum In:
Arch Ophthalmol. 2010 Dec;128(12):1623

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Vision- and health-related quality of life in patients with behcet uveitis.
Next Document:  Monocyte chemoattractant protein 1, intercellular adhesion molecule 1, and vascular cell adhesion mo...