Effects of Antithrombotic Agents on Ophthalmological Outcomes, Cardiovascular Risk, and Mortality in Hypertensive Patients with Retinal Vein Occlusion: An Exploratory Retrospective Study
Abstract
:1. Background and Objectives
2. Materials and Methods
2.1. Ophthalmological Evaluation
2.2. Statistical Analysis
3. Results
3.1. Ophthalmological Outcomes
3.2. Survival Analysis
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Baseline Variable | All Patients | Treated | Untreated | p |
---|---|---|---|---|
N = 80 | 56 | 24 | ||
Age (years) | 68 ± 12 | 69 ± 12 | 66 ± 14 | 0.311 |
Male sex (n (%)) | 39 (49) | 26 (46) | 13 (54) | 0.696 |
Charlson Comorbidity Index | 3.2 ± 1.9 | 3.4 ± 1.9 | 2.6 ± 2.0 | 0.092 |
BMI (Kg/m2) | 26.4 ± 4.8 | 26.4 ± 4.8 | 26.6 ± 4.7 | 0.846 |
Active smoking (n (%)) | 13 (16) | 8 (15) | 5 (21) | 0.534 |
CVD (n (%)) | 20 (25) | 18 (32) | 2 (8) | 0.026 |
Office SBP (mm Hg) | 146 ± 19 | 144 ± 12 | 149 ± 19 | 0.359 |
Office DBP (mm Hg) | 82 ± 9 | 82 ± 8 | 85 ± 10 | 0.208 |
Dyslipidemia (n (%)) | 29 (36) | 22 (39) | 7 (29) | 0.454 |
Total cholesterol (mg/dL) | 218 ± 41 | 217 ± 40 | 220 ± 44 | 0.773 |
LDL cholesterol (mg/dL) | 136 ± 36 | 135 ± 37 | 138 ± 33 | 0.654 |
HDL cholesterol (mg/dL) | 59 ± 16 | 58 ± 17 | 61 ± 14 | 0.452 |
Triglycerides (mg/dL) | 121 ± 61 | 124 ± 65 | 115 ± 48 | 0.497 |
Diabetes (n (%)) | 14 (18) | 11 (20) | 3 (12) | 0.536 |
HbA1c (%) | 5.7 ± 0.8 | 5.8 ± 0.8 | 5.5 ± 0.6 | 0.065 |
Plasma fibrinogen (mg/dL) | 398 ± 111 | 399 ± 96 | 397 ± 142 | 0.962 |
CRP (mg/L) | 1.93 (0.99–3.87) | 2.04 (0.96–3.95) | 1.58 (1.01–3.07) | 0.712 |
Plasma creatinine (mg/dL) | 1.04 ± 0.40 | 1.07 ± 0.46 | 0.98 ± 0.16 | 0.218 |
eGFR (mL/min/1.73m2) | 66 ± 14 | 64 ± 15 | 69 ± 12 | 0.132 |
Ophthalmological variables | ||||
CRVO (n (%)) | 41 (51) | 30 (54) | 11 (46) | 0.628 |
BRVO (n (%)) | 39 (49) | 26 (46) | 13 (54) | 0.628 |
BCVA (logMAR) | 0.78 ± 0.70 | 0.85 ± 0.73 | 0.64 ± 0.62 | 0.189 |
Retinal ischemia (n (%)) | 9 (11) | 7 (13) | 2 (9) | 0.905 |
Retinal neovascularization (n (%)) | 2 (3) | 2 (4) | 0 | - |
Hemovitreus (n (%)) | 4 (5) | 1 (2) | 3 (8) | 0.087 |
Rubeosis iridis (n (%)) | 0 | 0 | 0 | - |
Neovascular glaucoma (n (%)) | 0 | 0 | 0 | - |
Baseline Variable | All Patients | Treated | Untreated | p |
---|---|---|---|---|
Ophthalmological variables | ||||
Retinal ischemia (n (%)) | 4 (5) | 4 (7) | 0 | - |
Retinal neovascularization (n (%)) | 2 (2.5) | 2 (3.6) | 0 | - |
Hemovitreus (n (%)) | 1 (1.3) | 1 (1.8) | 0 | - |
Rubeosis iridis (n (%)) | 2 (2.5) | 2 (3.6) | 0 | - |
Neovascular glaucoma (n (%)) | 3 (3.8) | 2 (3.6) | 1 (4.2) | 0.845 |
Composite endpoint components | ||||
Composite endpoint (n (%)) | 29 (36) | 21 (38) | 8 (33) | 0.803 |
Median time of composite endpoint occurrence (years) | 5.3 (3.9–7.9) | 5.8 (4.7–7.9) | 4.4 (3.1–7.5) | 0.518 |
All-cause deaths (n (%)) | 23 (29) | 16 (29) | 7 (29) | 0.942 |
Major fatal cardiovascular events (n (%)) | 6 (7.5) | 4 (7.1) | 2 (8.3) | 0.904 |
Major non-fatal cardiovascular events (n (%)) | 7 (8.8) | 6 (11) | 1 (4.2) | 0.668 |
Median follow-up time (years) | 8.7 (7.5–9.9) | 8.7 (7.4–9.6) | 8.7 (7.6–10) | 0.797 |
Median survival time of died patients (years) | 4.8 (2.9–7.1) | 4.9 (3.5–6.9) | 4.4 (2.9–6.2) | 0.579 |
Baseline Variable | Univariate Analysis | Multivariate Analysis | ||||
---|---|---|---|---|---|---|
HR | 95% CI | p | HR | 95% CI | p | |
Age (years) | 1.153 | 1.091–1.218 | <0.001 | 1.082 | 1.008–1.163 | 0.030 |
Male sex (yes/no) | 1.389 | 0.668–2.887 | 0.380 | |||
Charlson Comorbidity Index | 2.093 | 1.620–2.704 | <0.001 | 1.700 | 1.171–2.471 | 0.005 |
Diabetes (yes/no) | 0.920 | 0.351–2.412 | 0.865 | |||
Dyslipidemia (yes/no) | 0.577 | 0.255–1.303 | 0.186 | |||
CVD (yes/no) | 3.174 | 1.523–6.614 | 0.002 | 0.855 | 0.338–2.165 | 0.741 |
BMI (Kg/m2) | 0.960 | 0.887–1.039 | 0.315 | |||
Active smoker (yes/no) | 0.693 | 0.241–1.993 | 0.497 | |||
SBP (mm Hg) | 1.003 | 0.984–1.023 | 0.736 | |||
DBP (mm Hg) | 0.999 | 0.958–1.041 | 0.949 | |||
Total cholesterol (mg/dL) | 0.999 | 0.990–1.008 | 0.823 | |||
LDL cholesterol (mg/dL) | 1.001 | 0.990–1.011 | 0.899 | |||
HDL cholesterol (mg/dL) | 1.006 | 0.984–1.028 | 0.610 | |||
Triglycerides (mg/dL) | 0.994 | 0.985–1.003 | 0.174 | |||
HbA1c (%) | 1.284 | 0.860–1.918 | 0.222 | |||
Fibrinogen (mg/dL) | 1.001 | 0.998–1.004 | 0.502 | |||
Log (CRP (mg/L)) | 1.417 | 1.074–1.868 | 0.014 | 1.147 | 0.840–1.567 | 0.389 |
Plasma creatinine (mg/dL) | 1.167 | 0.578–2.357 | 0.667 | |||
eGFR (ml/min/1.73 m2) | 0.978 | 0.957–0.999 | 0.046 | 1.003 | 0.980–1.026 | 0.820 |
CRVO (yes/no) | 1.033 | 0.498–2.140 | 0.931 | |||
BRVO (yes/no) | 0.968 | 0.467–2.006 | 0.931 | |||
Antithrombotic agents (yes/no) | 1.106 | 0.490–2.498 | 0.808 | 0.585 | 0.218–1.566 | 0.286 |
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Bertoli, F.; Bais, B.; De Silvestri, D.; Mariotti, B.; Veritti, D.; Cavarape, A.; Catena, C.; Lanzetta, P.; Sechi, L.A.; Colussi, G. Effects of Antithrombotic Agents on Ophthalmological Outcomes, Cardiovascular Risk, and Mortality in Hypertensive Patients with Retinal Vein Occlusion: An Exploratory Retrospective Study. Medicina 2021, 57, 1017. https://doi.org/10.3390/medicina57101017
Bertoli F, Bais B, De Silvestri D, Mariotti B, Veritti D, Cavarape A, Catena C, Lanzetta P, Sechi LA, Colussi G. Effects of Antithrombotic Agents on Ophthalmological Outcomes, Cardiovascular Risk, and Mortality in Hypertensive Patients with Retinal Vein Occlusion: An Exploratory Retrospective Study. Medicina. 2021; 57(10):1017. https://doi.org/10.3390/medicina57101017
Chicago/Turabian StyleBertoli, Federica, Bruno Bais, Daniele De Silvestri, Barbara Mariotti, Daniele Veritti, Alessandro Cavarape, Cristiana Catena, Paolo Lanzetta, Leonardo Alberto Sechi, and GianLuca Colussi. 2021. "Effects of Antithrombotic Agents on Ophthalmological Outcomes, Cardiovascular Risk, and Mortality in Hypertensive Patients with Retinal Vein Occlusion: An Exploratory Retrospective Study" Medicina 57, no. 10: 1017. https://doi.org/10.3390/medicina57101017