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抗血栓药物对伴有视网膜静脉阻塞的高血压患者眼科结局、心血管风险和死亡率的影响:一项探索性回顾性研究。

Effects of Antithrombotic Agents on Ophthalmological Outcomes, Cardiovascular Risk, and Mortality in Hypertensive Patients with Retinal Vein Occlusion: An Exploratory Retrospective Study.

机构信息

Division of Ophthalmology, Monfalcone-Gorizia Hospital (ASUGI), 34074 Monfalcone, Italy.

Thrombosis Prevention Unit, Division of Internal Medicine, Academic Hospital of Udine (ASUFC), 33100 Udine, Italy.

出版信息

Medicina (Kaunas). 2021 Sep 25;57(10):1017. doi: 10.3390/medicina57101017.

Abstract

: Because few data are available, the aim of this study is to analyze the effects of antithrombotic agents (ATAs) on visual function and long-term risk of cardiovascular events and mortality in hypertensive patients with retinal vein occlusion (RVO). : Hypertensive patients with RVO were consecutively selected from 2008 to 2012 and followed for a median of 8.7 years. Ophthalmologists evaluated and treated RVO complications, and best-corrected visual acuity (BCVA) was checked at each visit during the first one year of follow-up. Survival analysis was conducted on the rate of the composite endpoint of all-cause deaths or non-fatal cardiovascular events. : Retrospectively, we collected data from 80 patients (age 68 ± 12 years, 39 males). Central and branch RVO was present in 41 and 39 patients, respectively, and 56 patients started ATAs (50 antiplatelet drugs, 6 warfarin, and 2 low-molecular weight heparin). Average BCVA of the cohort did not change significantly during one-year of follow-up. The only predictor of BCVA was the baseline BCVA value. There was a reduction in proportion and severity of macular edema and an increase in the cumulative proportion of retinal vein patency reestablishment during the follow-up, independent of treatment. ATAs had no effects on one-year BCVA, intraocular complications, or the composite endpoint rate. : In this exploratory study, ATAs had no effect on BCVA during the first one year of follow-up and on the composite endpoint during the long-term follow-up. Further prospective studies need to be conducted with an accurate standardization of the intraocular and antithrombotic treatment to define the positive or negative role of ATAs in hypertensive patients with RVO.

摘要

: 由于数据有限,本研究旨在分析抗血栓药物(ATAs)对高血压性视网膜静脉阻塞(RVO)患者的视觉功能和心血管事件及死亡率的长期风险的影响。 : 2008 年至 2012 年连续选择高血压性 RVO 患者,并随访中位数为 8.7 年。眼科医生评估和治疗 RVO 并发症,并在随访的第一年每次就诊时检查最佳矫正视力(BCVA)。对全因死亡或非致死性心血管事件的复合终点发生率进行生存分析。 : 回顾性收集了 80 例患者(年龄 68±12 岁,39 例男性)的数据。41 例和 39 例患者分别存在中心性和分支性 RVO,56 例患者开始使用 ATAs(50 例抗血小板药物、6 例华法林和 2 例低分子肝素)。在一年的随访期间,队列的平均 BCVA 没有显著变化。BCVA 的唯一预测因素是基线 BCVA 值。在随访过程中,黄斑水肿的比例和严重程度降低,视网膜静脉再通的累积比例增加,与治疗无关。ATAs 对一年的 BCVA、眼内并发症或复合终点发生率均无影响。 : 在这项探索性研究中,ATAs 在随访的第一年对 BCVA 没有影响,在长期随访中对复合终点也没有影响。需要进一步进行前瞻性研究,以准确规范眼内和抗血栓治疗,以确定 ATAs 在高血压性 RVO 患者中的积极或消极作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c32/8537937/c7d41efdfccc/medicina-57-01017-g001.jpg

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