First Author: J.Kwon SOUTH KOREA
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To evaluate the risk of myocardial infarction (MI) after receiving intravitreal bevacizumab (IVB) injection.
We retrospectively reviewed the charts of patients who had received IVB injection in 2016, and grouped them according to whether they received the injection for age-related macular degeneration (AMD), diabetes-related complications, or retinal vein occlusion (RVO). We then investigated the prevalence of MI within 2 months.
The medical records of all patients treated with IVB injections during 2016, at St. Vincent Hospital, Suwon, Republic of Korea, were reviewed retrospectively. Inclusion criteria included receiving IVB injection because of AMD, diabetes-related complications such as PDR with vitreous haemorrhage or centre-involved DME, and macular edema (ME) because of RVO. Patients were injected with 1.25 mg of bevacizumab, irrespective of the type of disease, and were diagnosed with MI within 2 months after the IVB injection. We excluded patients who were not followed-up until 2 months after the injection. The Kruskal-Wallis test was used to compare age and the number of injections among the three groups. Tukey’s post hoc analysis was used to compensate for multiple statistical analyses and comparisons. The chi-square test and Fisher’s extract test were used to compare the distribution of sex and the prevalence of MI among the groups. Statistical analyses were performed using R software.
During 2016, 742 patients were enrolled and received a total of 1,785 IVB injections. Seven patients were diagnosed with MI within 2 months after receiving an IVB injection. Of 289 AMD patients, 2 were diagnosed with MI; of 320 diabetes-related complications patients, 3 were diagnosed with MI; and of 133 RVO patients, 2 were diagnosed with MI. All MIs occurred between 3 days and 3 weeks after IVB injection (mean = 14.00 ± 6.45 days). Five patients had been treated with diabetes mellitus (DM) medications and four had been treated with hypertension medications. Two of these patients had a history of previous MI and one had a history of cerebrovascular infarction.
The number of patients was too small to determine the possible association between IVB injection and MI. There was no significant difference in MI prevalence after IVB injection according to the reason for receiving the injection. However, considering the intervals between IVB injection and MI, care should be taken when administering IVB injections, especially to patients with risk factors.