PMID- 35300625
OWN - NLM
STAT- MEDLINE
DCOM- 20220321
LR  - 20220324
IS  - 1471-2415 (Electronic)
IS  - 1471-2415 (Linking)
VI  - 22
IP  - 1
DP  - 2022 Mar 17
TI  - Effect of anticoagulant/antiplatelet therapy on the development and progression 
      of diabetic retinopathy.
PG  - 127
LID - 10.1186/s12886-022-02323-z [doi]
LID - 127
AB  - BACKGROUND: We investigated whether antiplatelet/anticoagulant (APAC) therapy can 
      protect patients with type 2 diabetes mellitus (T2DM) from the development or 
      progression of diabetic retinopathy (DR). METHODS: This is a retrospective cohort 
      study using Longitudinal Health Insurance Database in Taiwan. A total of 73,964 
      type 2 diabetic patients older than 20 years old were included. Hazard ration 
      (HR) of non-proliferative DR (NPDR), proliferative DR (PDR), and diabetic macular 
      edema (DME) were analyzed with APAC usage as a time-dependent covariate. Age, 
      sex, comorbidities, and medicines were further adjusted in a multi-variable 
      model. Contributions of respective APAC was investigated with sensitivity 
      analysis. RESULTS: Compared with nonusers, APAC users had a lower cumulative 
      incidence of NPDR (P < 0.001), overall incidence of NPDR (10.7 per 1000 
      person-years), and risk of developing NPDR (adjusted HR = 0.78, 95% 
      CI = 0.73-0.83). However, no significant differences were observed between APAC 
      users and nonusers in the risks of PDR or DME. Hypertension, diabetic nephropathy 
      and diabetic neuropathy were risk factors for NDPR development, while heart 
      disease, cardiovascular disease, peripheral arterial occlusive disease, and 
      statin usage were covariates decreasing NPDR development. Aspirin and 
      Dipyridamole showed significant protection against NPDR development. Clopidogrel, 
      Ticlopidine, and warfarin showed enhanced protection in combination with aspirin 
      usage. CONCLUSIONS: APAC medications have a protective effect against NPDR 
      development. Diabetic patients benefit from single use of aspirin or dipyridamole 
      on prevention of NPDR.
CI  - (c) 2022. The Author(s).
FAU - Jeng, Chi-Juei
AU  - Jeng CJ
AD  - Department of Ophthalmology, Taipei Medical University-Shuang-Ho hospital, 
      Ministry of Health and Welfare, New Taipei City, Taiwan.
AD  - Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan 
      University, Taipei, Taiwan.
AD  - Department of Ophthalmology, School of Medicine, National Taiwan University 
      Hospital, Taipei, Taiwan.
FAU - Hsieh, Yi-Ting
AU  - Hsieh YT
AD  - Department of Ophthalmology, School of Medicine, National Taiwan University 
      Hospital, Taipei, Taiwan.
FAU - Lin, Cheng-Li
AU  - Lin CL
AD  - Management Office for Health Data, China Medical University, Taichung, Taiwan. 
      orangechengli@gmail.com.
FAU - Wang, I-Jong
AU  - Wang IJ
AUID- ORCID: 0000-0002-3045-0614
AD  - Department of Ophthalmology, School of Medicine, National Taiwan University 
      Hospital, Taipei, Taiwan. ijong@ms8.hinet.net.
AD  - Graduate Institute of Clinical Medical Science, China Medical University, 
      Taichung, Taiwan. ijong@ms8.hinet.net.
LA  - eng
PT  - Journal Article
DEP - 20220317
PL  - England
TA  - BMC Ophthalmol
JT  - BMC ophthalmology
JID - 100967802
RN  - 0 (Anticoagulants)
RN  - 0 (Platelet Aggregation Inhibitors)
SB  - IM
MH  - Adult
MH  - Anticoagulants
MH  - *Diabetes Mellitus, Type 2/complications/drug therapy
MH  - *Diabetic Retinopathy/drug therapy/epidemiology/etiology
MH  - Humans
MH  - *Macular Edema/epidemiology
MH  - Platelet Aggregation Inhibitors/therapeutic use
MH  - Retrospective Studies
MH  - Young Adult
PMC - PMC8932222
OTO - NOTNLM
OT  - Anticoagulant
OT  - Antiplatelet
OT  - Aspirin
OT  - Diabetic retinopathy
COIS- The authors declare that they have no known competing financial interests or 
      personal relationships that could have appeared to influence the work reported in 
      this paper.
EDAT- 2022/03/19 06:00
MHDA- 2022/03/22 06:00
PMCR- 2022/03/17
CRDT- 2022/03/18 05:35
PHST- 2020/09/09 00:00 [received]
PHST- 2022/02/21 00:00 [accepted]
PHST- 2022/03/18 05:35 [entrez]
PHST- 2022/03/19 06:00 [pubmed]
PHST- 2022/03/22 06:00 [medline]
PHST- 2022/03/17 00:00 [pmc-release]
AID - 10.1186/s12886-022-02323-z [pii]
AID - 2323 [pii]
AID - 10.1186/s12886-022-02323-z [doi]
PST - epublish
SO  - BMC Ophthalmol. 2022 Mar 17;22(1):127. doi: 10.1186/s12886-022-02323-z.