Prospective Association between Diabetic Retinopathy and Cardiovascular Disease-A Systematic Review and Meta-analysis of Cohort Studies
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AbstractBackground: Diabetic retinopathy (DR) is linked to increased risk of cardiovascular (CV) disease. However, the effect size of the association was not consistent. In this study, we performed a systematic review and meta-analysis of available cohort studies to determine the association between DR and CV disease, and to investigate the factors that influence the association. Methods: Terms related to DR and CV disease were searched from MEDLINE and EMBASE database. High-quality articles (Newcastle-Ottawa scales above 6) conducted in cohort studies reporting the association between DR and CV disease were identified. Study-specific estimates were pooled using random effects with inverse variance meta-analysis. Subgroup analysis was performed according to diabetes types. Heterogeneity of included studies was assessed using the I-2 test. The cause of the heterogeneity was examined using metaregression analyses. Results: A total of 13 studies representing 17,611 patients without CV disease at baseline were included. At follow-up, there were 1457 CV disease-related incidences. Overall, DR was associated with increased risk of CV disease (relative risk [RR]: 2.42, 95% confidence interval [CI]: 1.77-3.31) in diabetes. Specifically, the RR was 3.59 (95% CI: 1.79-7.20) for type 1 diabetes and 1.81 (95% CI: 1.47-2.23) for type 2 diabetes. Significant heterogeneity was found in studies with type 1 diabetes. Metaregression analysis showed that baseline systolic blood pressure was a key factor leading to the heterogeneity. Conclusion: In conclusion, DR is significantly associated with CV disease incidence and CV disease-related mortality in diabetes. Patients with DR may need more intensive management to control future CV disease attacks. (C) 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.
All Author(s) ListGuo VY, Cao B, Wu XY, Lee JJW, Zee BCY
Journal nameJournal of Stroke and Cerebrovascular Diseases
Volume Number25
Issue Number7
PublisherWB Saunders
Pages1688 - 1695
LanguagesEnglish-United Kingdom
KeywordsCardiovascular disease; diabetes; diabetic retinopathy; meta-analysis; systematic review
Web of Science Subject CategoriesCardiovascular System & Cardiology; Neurosciences; Neurosciences & Neurology; Peripheral Vascular Disease

Last updated on 2021-24-10 at 00:04