Association between Cardiovascular Adverse Events With Intra
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A Study was conducted to evaluate systemic adverse events (SAEs) associated with intravitreal anti-VEGF drugs compared with non–anti-VEGF treatments in patients with ocular diseases. Randomized clinical trials conducted in adults with retinal diseases who received intravitreal anti-VEGF drugs.

Significant cardiovascular events (MACEs) and overall mortality were the primary outcomes. Nonocular hemorrhage, MACE materials, other cardiovascular outcomes, serious SAEs, and all SAEs were among the secondary outcomes.

--A total of 74 randomized clinical trials were analyzed: 32 trials (43%) included 14190 patients with age-related macular degeneration (AMD), 24 included 5424 patients with diabetic retinopathy (diabetic macular edema or proliferative diabetic retinopathy), 17 trials included 3757 patients with retinal vein occlusion, and 1 trial included 122 patients with myopic choroidal neovascularization.

--Anti-VEGF drug administration did not increase MACEs compared with control agents (odds ratio [OR], 1.16) or total mortality (OR, 1.27).

--There was an interaction in mortality risk depending on the underlying disease with an increase (OR, 1.80) in the risk of death in patients with diabetic retinopathy; however, no increase was observed in patients with AMD or retinal vein occlusion.

--Administration of anti-VEGF drugs increased the risk of nonocular hemorrhage (OR, 1.46), mainly in patients with AMD.

In conclusion, intravitreal anti-VEGF was not linked to an increase in MACEs. Increased mortality in diabetic patients and those with nonocular hemorrhages, especially in those with AMD, may be a warning sign.