Original articleAnnual Rates of Arterial Thromboembolic Events in Medicare Neovascular Age-Related Macular Degeneration Patients
Section snippets
Data Sources and Study Population
The data sources for our study were the Medicare standard analytic files for 2001 to 2003. These files contain all inpatient, outpatient, physician, and supplier claims for 5% of all Medicare beneficiaries enrolled in the fee-for-service Medicare program. The standard analytic files contain patient characteristics; details regarding hospitalizations, diagnostic testing, and therapeutic procedures; and physician services (inpatient and outpatient). Unique patient identification numbers allow
Results
During our study period, the 5% Medicare database consisted of about 2 million people with an average age of 75 years, 59% of whom were female and 86% white. Our study included 15 771 new-onset neovascular AMD patients and 46 408 controls matched by age, gender, race, and length of data within the database (Table 1). This subset was older than the overall Medicare database population, with an average age of 80.5 years, and predominantly female (65%) and white (95.9%). Over half of the patients
Discussion
In this retrospective study of a large national claims database, neovascular AMD patients did not have an increased risk of MI or ischemic CVA compared with controls. Neovascular AMD patients had higher rates of comorbidities that could have increased the risk of ATEs, including diabetes, hyperlipidemia, and hypertension. Myocardial infarction and CVA event rates for both neovascular AMD patients and controls increased with age, with the exception of one age group (65–70 years) for MI. The
References (32)
- et al.
Dietary glycemic index and carbohydrate in relation to early age-related macular degeneration
Am J Clin Nutr
(2006) - et al.
The association of cardiovascular disease with the long-term incidence of age-related maculopathyThe Beaver Dam Eye Study
Ophthalmology
(2003) - et al.
Biomarkers of cardiovascular disease as risk factors for age-related macular degeneration
Ophthalmology
(2005) - et al.
Age-related maculopathy in a multiracial United States population: the National Health and Nutrition Examination Survey III
Ophthalmology
(1999) - et al.
Early age-related maculopathy in the Cardiovascular Health Study
Ophthalmology
(2003) - et al.
Age-related macular degeneration is associated with incident myocardial infarction among elderly Americans
Ophthalmology
(2007) - et al.
Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases
J Clin Epidemiol
(1992) - et al.
The use of automated data to identify complications and comorbidities of diabetes: a validation study
J Clin Epidemiol
(1999) Prevalence of age-related macular degeneration in the United States
Arch Ophthalmol
(2004)Age-related macular degeneration is the leading cause of blindness
JAMA
(2004)
The Beaver Dam Eye Study: the relation of age-related maculopathy to smoking
Am J Epidemiol
Smoking and age related macular degeneration: the number of pack years of cigarette smoking is a major determinant of risk for both geographic atrophy and choroidal neovascularisation
Br J Ophthalmol
Age-related macular degeneration and risk for stroke
Ann Intern Med
Prospective study of intake of fruits, vegetables, vitamins, and carotenoids and risk of age-related maculopathy
Arch Ophthalmol
Hypertension, cardiovascular disease, and age-related macular degeneration
Arch Ophthalmol
Systemic hypertension and age-related maculopathy in the Framingham Study
Arch Ophthalmol
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Manuscript no. 2007-455.
Analysis conducted by ZD Associates was supported in part by Genentech, Inc.