Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Pharmacoepidemiol Drug Saf. 2021 Feb;30(2):178-188. doi: 10.1002/pds.5145. Epub 2020 Oct 14.
The association between cardioprotective aspirin and risk of age-related macular degeneration (AMD) is still controversial up to date. We aimed to analyze the risk of AMD between aspirin users and non-aspirin users.
This was a retrospective cohort study by using claims data from the National Health Insurance Research Database. Patients aged more than 45 years old who initiated aspirin during 2002 to 2012 were followed till 2013. We first selected an age and sex-matched cohort, then identified aspirin users and non-aspirin users as propensity score-matched cohort. Cox proportional hazard regression model was applied to compare their hazards and 95% confidence intervals. Incidence of newly developed AMD, neovascular AMD, and other-AMD was calculated.
We identified 204 085 regular aspirin users and 478 048 non-aspirin users from our datasets. The univariate HR was 2.85 (95% CI, 2.75-2.96), and the multivariate HR was 2.54 (95% CI, 2.44-2.65). In the PS-matched cohort, the HR was 2.38 (95% CI, 2.25-2.52). The incidence of aspirin users for AMD risk was 11.95 per 1000 person-year, while the incidence of non-aspirin users was only 3.92 per 1000 person-year.
Patients with regular use of aspirin had higher risk in developing AMD compared to non-aspirin users and suggest to have regular visual acuity and funduscopic examination.
目前，关于阿司匹林的心脏保护作用与年龄相关性黄斑变性（AMD）风险之间的关联仍存在争议。我们旨在分析阿司匹林使用者和非阿司匹林使用者之间发生 AMD 的风险。
这是一项使用来自全民健康保险研究数据库的理赔数据进行的回顾性队列研究。2002 年至 2012 年期间开始使用阿司匹林的年龄大于 45 岁的患者被随访至 2013 年。我们首先选择了一个年龄和性别匹配的队列，然后将阿司匹林使用者和非阿司匹林使用者确定为倾向评分匹配队列。应用 Cox 比例风险回归模型比较了他们的风险比及其 95%置信区间。计算了新发 AMD、新生血管性 AMD 和其他 AMD 的发生率。
我们从数据集中确定了 204085 名常规阿司匹林使用者和 478048 名非阿司匹林使用者。单变量 HR 为 2.85（95%CI，2.75-2.96），多变量 HR 为 2.54（95%CI，2.44-2.65）。在 PS 匹配队列中，HR 为 2.38（95%CI，2.25-2.52）。阿司匹林使用者发生 AMD 的风险为 11.95 人年/1000 人，而非阿司匹林使用者仅为 3.92 人年/1000 人。
与非阿司匹林使用者相比，经常使用阿司匹林的患者发生 AMD 的风险更高，建议定期进行视力和眼底检查。
