Hospitalized cardiovascular events in patients with diabetic macular edema

This was a retrospective cohort study of a commercially insured population in an administrative claims database. DME subjects (n？=？3519) and diabetes controls without retinal disease (n？=？10557) were matched by age and gender. Healthcare claims were analyzed for the study period from 1 January 2002 to 31 December 2005. Incidence and adjusted rate ratios of hospitalized MI and CVA events were then calculated.The adjusted rate ratio for MI was 2.50 (95% CI: 1.83-3.41, p？<？0.001) for DME versus diabetes controls. Predictors of MI events were heart disease, history of acute MI, and prior use of antiplatelet or anticoagulant drugs. The adjusted rate ratio for CVA was 1.98 (95% CI: 1.39-2.83, p？<？0.001) for DME versus diabetes controls. Predictors of CVA events were cardiac arrhythmia, Charlson comorbidity scores, history of CVA, hyperlipidemia, and other cerebrovascular diseases.Event rates of MI or CVA were higher in patients with DME than in diabetes controls. This study is one of few with sufficient sample size to accurately estimate the relationship between DME and cardiovascular outcomes.Diabetic macular edema (DME) may occur at any stage of diabetic retinopathy (DR) and is the leading cause of moderate vision loss in adults of working age [1]. The prevalence of DME is about one-tenth that of background DR and one-third that of proliferative DR [2]. Microvascular complications, like DR and DME, are associated with progressive or uncontrolled diabetes. Cardiovascular events, such as myocardial infarctions (MI) or cerebrovascular accidents (CVA)/stroke, are known macrovascular complications of diabetes mellitus. Microvascular complications of diabetes are commonly diagnosed as eye diseases; however, pathologic changes to cardiac and cerebral circulation also occur [3].The association between DR and cardiovascular outcomes has been extensively studied [4-8] and reviewed [9]. However, cardiovascular outcomes in DME patients have not been well examined; previously publis