Diabetic retinopathy, its progression and incident cardiovascular events in the ACCORD trial

Gerstein HC, Ambrosius WT, Danis R, et al. Diabetic retinopathy, its progression and incident cardiovascular events in the ACCORD trial. Diabetes Care. 2013;36(5):1266-1271.

Design 

The presence and severity of diabetic retinopathy are independent determinants of future cardiovascular events among individuals with diabetes. The present study analyzed data from a subset of participants from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study who were enrolled in the ACCORD Eye study. It assessed the effect of interventions on retinal pathology at baseline and after 4 years' follow-up among 2,856 participants (mean age 61 yrs) who had baseline retinal photographs.

Data were assessed to confirm the relationship between severity of baseline retinopathy and cardiovascular outcomes, and to determine whether deterioration of retinopathy with time is linked to cardiovascular outcomes.  (Click here for slide)  

Results  

Individuals with progressively greater severity of retinopathy at baseline had higher baseline A1C and systolic blood pressure (P for trend <0.0001) and were more likely to experience the ACCORD primary endpoint (myocardial infarction or stroke; P<0.001). 

Individuals with worsening of retinopathy over 4 years had progressively higher A1C levels, systolic blood pressure, and LDL-C at baseline (P<0.01) and were more likely to experience the ACCORD primary endpoint (P<0.001) and MI (P=0.01). The hazard ratio for the primary endpoint increased by 38% (HR, 1.38; 1.10-1.74) for each change in retinopathy severity. The hazard ratio for MI increased by 40% (HR, 1.40; 1.08-1.80) for every change in retinopathy severity. (Click here for slide)  

Related content: 

Slide: ACCORD: Design 

 

February 2013

This overview was created by KnowledgePoint360 Group, LLC, and was not associated with funding via an educational grant or a promotional/commercial interest.  

Last Modified: 8/5/2014