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Risks of newly onset hemorrhagic stroke in patients with neovascular age‐related macular degeneration
Author(s) -
Lee WanJu Annabelle,
Cheng ChingLan,
Lee ChengHan,
Kao Yang YeaHuei,
Lin SwuJane,
Hsieh ChengYang
Publication year - 2017
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.4299
Subject(s) - medicine , stroke (engine) , macular degeneration , myocardial infarction , proportional hazards model , retrospective cohort study , hazard ratio , incidence (geometry) , cohort study , cohort , population , ophthalmology , confidence interval , mechanical engineering , physics , environmental health , optics , engineering
Abstract Purpose Age‐related macular degeneration (AMD) is an eye disease causing blindness in the elderly. It shares many common possible pathogenic mechanisms with cardiovascular diseases. Many studies have discussed the association between AMD and stroke, but the results were inconsistent. Our aim was to determine the associations between neovascular AMD and the risk of stroke in the Taiwanese population. Methods This is a retrospective cohort study. We used claims data from National Health Insurance Research Database. Patients aged more than 45 years without stroke, myocardial infarction, or any AMD were selected from 2001 to 2008 and followed until 2010. The index date was defined as the date of nAMD diagnosis (ICD‐9 code, 362.52). The comparison group was patients without an nAMD diagnosis with age‐ and sex‐matched to nAMD subjects at a ratio of up to 10 to 1. Kaplan‐Meier survival analysis and Cox regression analysis were used. The incidence of stroke events (ICD‐9 codes, 430‐434) and their subtypes (hemorrhagic and ischemic) were primary outcomes. Secondary outcomes included acute myocardial infarction (AMI), composite AMI/stroke, and all‐cause mortality. Results Patients with nAMD had a higher risk of developing stroke, with an adjusted HR of 1.30 (95% CI, 1.01‐1.68). A higher risk for hemorrhagic stroke (HR, 1.70, 95% CI, 1.03‐2.83) was also found. No significant differences were observed in ischemic stroke, the composite of AMI/stroke, and all‐cause mortality. Conclusions Patients with nAMD had a significantly higher risk of developing stroke, which was driven mainly by the increased risk of developing the hemorrhagic subtype.