糖尿病患者内腔抗血管内皮生长因子治疗的心血管结果:现实世界的数据分析
Jonathan Y M Lai1,2,3, David R Riley2,3, Matthew Anson2,3
1St. Paul's Eye Unit, Liverpool University NHS Hospital Foundation Trust, Liverpool, UK.
概括
糖尿病视网膜病变的静脉内抗血管内皮生长因子 (anti-VEGF) 治疗没有显示出糖尿病患者心血管疾病 (CVD) 事件的显著增加. 这项实践研究证实了针对这一群体的抗VEGF注射的安全性.
科学领域:
- 眼科医生 眼科 眼科
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
背景情况:
- 系统性抗VEGF治疗与心血管疾病 (CVD) 事件有关,这对糖尿病患者来说是一个问题.
- 糖尿病增殖性视网膜病变通常需要静脉内抗VEGF治疗.
- 这项研究调查了糖尿病患者与内抗VEGF药物相关的CVD风险.
研究的目的:
- 评估糖尿病患者体内抗VEGF疗法和发生心血管疾病之间的关联.
- 为了比较接受抗VEGF治疗的糖尿病患者与接受激光或类固醇治疗的糖尿病患者的心血管疾病风险.
- 评估短期 (1,6,12个月) 的心血管结果.
主要方法:
- 使用了TriNetX全球现实世界电子医疗数据集.
- 包括患有糖尿病的成年人和没有心血管疾病史的人.
- 倾向性得分匹配 (1:1) 用于接受抗VEGF治疗与控制 (激光/类固醇治疗) 的队列.
- 结果包括死亡率,心肌梗塞,脑梗塞和心力衰竭.
主要成果:
- 在2205名糖尿病患者中,抗VEGF治疗显示12个月内心血管疾病风险的数值增加,但不具有统计学意义.
- 在死亡率,急性心肌梗塞,脑梗塞或心力衰竭方面没有观察到显著的风险过剩.
- 针对不同的时间点和结果报告了特定的相对风险 (RR) 和置信区间 (CI).
结论:
- 内抗VEGF治疗没有显示出糖尿病患者短期到中期内心血管事件的统计显著增加风险.
- 这项研究支持了糖尿病患者在没有先前存在心血管疾病的情况下进行内抗VEGF治疗的真实安全性.
- 心血管疾病事件的小数值增加需要持续监测,但在这种情况下不会否定治疗的安全性.
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