Centre for Vision Research, Department of Ophthalmology, University of Sydney, Sydney, Australia.
JAMA Intern Med. 2013 Feb 25;173(4):258-64. doi: 10.1001/jamainternmed.2013.1583.
To determine whether regular aspirin use is associated with a higher risk for developing age-related macular degeneration (AMD) by using analyzed data from a 15-year prospective cohort.
A prospective analysis was conducted of data from an Australian population-based cohort with 4 examinations during a 15-year period (1992-1994 to 2007-2009). Participants completed a detailed questionnaire at baseline assessing aspirin use, cardiovascular disease status, and AMD risk factors. Age-related macular degeneration was graded side-by-side from retinal photographs taken at each study visit to assess the incidence of neovascular (wet) AMD and geographic atrophy (dry AMD) according to the international AMD classification.
Of 2389 baseline participants with follow-up data available, 257 individuals (10.8%) were regular aspirin users and 63 of the 2389 developed neovascular AMD. Persons who were regular aspirin users were more likely to have incident neovascular AMD: the 15-year cumulative incidence was 9.3% in users and 3.7% in nonusers. After adjustment for age, sex, smoking, history of cardiovascular disease, systolic blood pressure, and body mass index, persons who were regular aspirin users had a higher risk of developing neovascular AMD (odds ratio [OR], 2.46; 95% CI, 1.25-4.83). The association showed a dose-response effect (multivariate-adjusted P = .01 for trend). Aspirin use was not associated with the incidence of geographic atrophy (multivariate-adjusted OR, 0.99; 95% CI, 0.59-1.65).
Regular aspirin use is associated with increased risk of incident neovascular AMD, independent of a history of cardiovascular disease and smoking.
通过对一项为期 15 年的前瞻性队列的分析数据进行研究，确定常规使用阿司匹林是否会增加年龄相关性黄斑变性（AMD）的发病风险。
对一项澳大利亚人群为基础的队列进行前瞻性分析，该队列在 15 年期间进行了 4 次检查（1992-1994 年至 2007-2009 年）。参与者在基线时完成了一份详细的问卷，评估阿司匹林使用情况、心血管疾病状况和 AMD 风险因素。根据国际 AMD 分类，在每次研究访问时从视网膜照片中并排评估 AMD 的等级，以评估新生血管性（湿性）AMD 和地理萎缩（干性 AMD）的发生率。
在有随访数据的 2389 名基线参与者中，有 257 名（10.8%）是常规阿司匹林使用者，有 63 名 2389 名参与者患有新生血管性 AMD。常规阿司匹林使用者更有可能发生新生血管性 AMD：使用者的 15 年累积发病率为 9.3%，而非使用者为 3.7%。在调整年龄、性别、吸烟、心血管疾病史、收缩压和体重指数后，常规阿司匹林使用者发生新生血管性 AMD 的风险更高（比值比[OR]，2.46；95%CI，1.25-4.83）。这种关联显示出剂量反应效应（多变量调整的趋势 P =.01）。阿司匹林的使用与地理萎缩的发生率无关（多变量调整的 OR，0.99；95%CI，0.59-1.65）。
常规使用阿司匹林与新发新生血管性 AMD 的风险增加相关，与心血管疾病和吸烟史无关。
