Is diabetic retinopathy related to subclinical cardiovascular disease?
| Autor: | Tien Yin Wong, Ryo Kawasaki, A. Richey Sharrett, Mary Frances Cotch, Ning Cheung, F.M. Amirul Islam, Barbara E.K. Klein, Ronald Klein, Daniel H. O'Leary |
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| Jazyk: | angličtina |
| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty Ethnic Groups Cardiovascular Diseases - Diagnosis - Epidemiology - Etiology Retinal Neovascularization Coronary Angiography Asymptomatic Macular Edema Coronary artery disease United States - Epidemiology Cohort Studies Electrocardiography Risk Factors Carotid artery disease Internal medicine Diabetes mellitus Macular Edema - Complications - Diagnosis - Epidemiology Ethnicity medicine Prevalence Humans cardiovascular diseases Diabetic Retinopathy - Complications - Diagnosis - Epidemiology Subclinical infection Aged Diabetic Retinopathy business.industry Odds ratio Diabetic retinopathy Middle Aged medicine.disease Retinal Neovascularization - Complications - Diagnosis - Epidemiology Aged 80 And Over United States Surgery Ophthalmology Epidemiologic Studies Cross-Sectional Studies Cardiovascular Diseases cardiovascular system Female medicine.symptom business Tomography X-Ray Computed Retinopathy |
| Popis: | Objective Persons with diabetic retinopathy (DR) have an increased risk of clinical cardiovascular events. This study aimed to determine whether DR is associated with a range of measures of subclinical cardiovascular disease (CVD) in persons without clinical CVD. Design Population-based, cross-sectional epidemiologic study. Participants Nine hundred twenty-seven persons with diabetes without clinical CVD in the Multi-Ethnic Study of Atherosclerosis. Methods Diabetic retinopathy was ascertained from retinal photographs according to modification of the Airlie House Classification system. Vision-threatening DR (VTDR) was defined as severe nonproliferative DR, proliferative DR, or clinically significant macular edema. Subclinical CVD measures were assessed and defined as follows: high coronary artery calcium (CAC) score, defined as CAC score of 400 or more; low ankle-brachial index (ABI), defined as ABI of less than 0.9; high ABI, defined as ABI of 1.4 or more; high carotid intima-media thickness (IMT), defined as highest 25% of IMT; and carotid stenosis, defined as more than 25% stenosis or presence of carotid plaque. Main Outcome Measures Associations between DR and subclinical CVD measures. Results The prevalence of DR and VTDR in this sample was 30.0% and 7.2%, respectively, and VTDR was associated with a high CAC score (odds ratio [OR], 2.33; 95% confidence interval [CI], 1.154.73), low ABI (OR, 2.54; 95% CI, 1.085.99), and high ABI (OR, 12.6; 95% CI, 1.14140.6) after adjusting for risk factors including hemoglobin A1c level and duration of diabetes. The association between VTDR and high CAC score remained significant after further adjustment for hypoglycemic, antihypertensive, and cholesterol-lowering medications. Diabetic retinopathy was not significantly associated with measures of carotid artery disease. Conclusions In persons with diabetes without a history of clinical CVD, the presence of advanced-stage DR is associated with subclinical coronary artery disease. These findings emphasize the need to be careful about the use of antivascular endothelial growth factor for the treatment of DR. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article. © 2011 American Academy of Ophthalmology. link_to_OA_fulltext |
| Databáze: | OpenAIRE |
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