Emily S. West, PhD (Baltimore, MD), Julia A. Haller, MD (Baltimore, MD), Winifred Werther, PhD (South San Francisco, CA), Pavel Napalkov, MD, MPH (South San Francisco, CA), Steven Francom, PhD (South San Francisco, CA), Steven Butler, PhD (South San Francisco, CA), Naveed Shams, MD, PhD (South San Francisco, CA)

PURPOSE:

Little is known about cardiovascular and cerebrovascular morbidities in patients with neovascular AMD. We therefore examined the incidence of myocardial infarction (MI) and cerebrovascular accident (CVA) in patients with neovascular AMD identified in a U.S. administrative healthcare claims database.

METHODS:

Patients were members of the Ingenix Lab/Rx DatabaseTM with a minimum of two diagnoses of exudative senile macular degeneration (ICD-9-CM code 362.52) between January 1, 2002 and June 30, 2005. The neovascular AMD index date was defined as the date of first diagnosis for neovascular AMD after a six month period with no diagnoses of MI or CVA. MI was defined by inpatient ICD-9-CM code 410. CVA was defined by in-patient ICD-9-CM codes 431, 432, 433.x1, 434.x1, and 436. Incident MI or CVA events were included after the neovascular AMD index date. Patients remained at risk during follow-up
and multiple events were counted. The annual incidence rates for MI and CVA were reported as percent.

RESULTS:

7,128 patients met the inclusion criteria. About 90% of patients had at least 3 months of follow-up time, and 66% of patients had more than 1 year. The cohort consisted of 60% women. The mean age at AMD index date was 76.5 years (median 78). The annual incidence rate for MI was 1.8% (95% CI: 1.6-2.1). The incidence rates for MI were slightly higher in men than in women. The incidence rate for CVA was 7.5% (95% CI: 2.3-2.9). The incidence rates for CVA increased with age for both men and women.

CONCLUSION:

This analysis provided a basis for establishing annual incidence rates of MI and CVA in patients with neovascular AMD. The annual incidence rate of CVA was higher than the annual incidence rate of MI in neovascular AMD patients in an administrative healthcare claims database.