November 3, 2020Open Access

Diabetic Retinopathy Predicts Cardiovascular Mortality in Diabetes: A Meta-analysis

Q: What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Diabetes mellitus (n=11239). Intervention: Diabetic retinopathy vs. No diabetic retinopathy. Primary outcome: Cardiovascular disease (CVD) mortality (RR 1.83, 95% CI 1.42, 2.36, p=<0.001).

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Key result

Diabetic retinopathy significantly predicts cardiovascular mortality in patients with diabetes, increasing the risk by 83% compared to those without retinopathy (RR 1.83).

Why the study?

The prognostic significance of diabetic retinopathy for cardiovascular diseases remained unclear.

Does diabetic retinopathy predict cardiovascular mortality in diabetic patients?

Population

11,239 diabetic subjects across 10 eligible cohort studies

Comparison

Diabetic retinopathy vs no diabetic retinopathy

Design

Meta-analysis of cohort studies

Authors

XXXiaohong XuYangtze University BSBo SunShandong University SZShan ZhongZhejiang University

Discussion

Member takes

Implication

Recognize diabetic retinopathy as a cardiovascular risk marker in diabetes; confirms associations and supports enhanced risk stratification.

Study Design

Type

Meta-Analysis (n=11,239)

Structured PICO

Does diabetic retinopathy predict cardiovascular mortality in diabetic patients?

Population

11,239 diabetic patients from 10 cohort studies followed for more than 2 years to evaluate the association between diabetic retinopathy and cardiovascular mortality.

Exposure

Presence of diabetic retinopathy (DR), including mild and severe DR

Comparator

Diabetic patients without diabetic retinopathy

Outcome

Cardiovascular disease (CVD) mortality (including death due to myocardial infarction, coronary heart disease, and heart failure)hard clinical

Main Result

Relative Risk: 1.83 (95% CI 1.42–2.36)

p-value: p=<0.001

Diabetic retinopathy is a significant risk marker for cardiovascular death in patients with diabetes, with severe DR predicting a doubled mortality risk.

Limitations

Different definitions of CVD among the included investigations
Some included investigations are retrospective cohort studies
No age- and gender-matched study included in the meta-analysis
Some included studies contain a relatively small sample size
Large heterogeneity among the studies
Unable to calculate the association of DR and specific cause of CVD death
Did not examine the contribution of individuals' baseline characteristics or therapeutic impacts
Did not evaluate the degree to which DR is itself a sign of poorly controlled CVD risk factors
Did not perform a further sub-group analysis comparing the different diagnostic procedure of DR
Findings cannot be directly applied in T1DM since the majority of participants were T2DM
Some included investigations are retrospective cohort studies, and there is no age- and gender-matched study
Failed to calculate the association of DR and specific cause of CVD death
Findings cannot be directly applied in T1DM

Cite This Study

Xu et al. (2020) conducted a meta-analysis in Diabetes mellitus (n=11,239). Diabetic retinopathy vs. No diabetic retinopathy was evaluated on Cardiovascular disease (CVD) mortality (RR 1.83, 95% CI 1.42, 2.36, p=<0.001). Diabetic retinopathy significantly predicts cardiovascular mortality in patients with diabetes, increasing the risk by 83% compared to those without retinopathy (RR 1.83).

synapsesocial.com/papers/6a99c6ca0c3d7640c6fdfb0d https://doi.org/10.21203/rs.3.rs-41693/v3

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Implication

Recognize diabetic retinopathy as a cardiovascular risk marker in diabetes; confirms associations and supports enhanced risk stratification.

Diabetic Retinopathy Predicts Cardiovascular Mortality in Diabetes: A Meta-analysis

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Diabetic Retinopathy Predicts Cardiovascular Mortality in Diabetes: A Meta-analysis

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider