JAMA finds anti‑VEGF safe post‑MI

Darius D. Bordbar and co-authors reported in JAMA Ophthalmology on March 26, 2026 that patients already receiving intravitreal anti-VEGF injections did not have worse mortality or major sequelae when treatment continued around the time of an acute stroke or myocardial infarction. (jamanetwork.com) The study used deidentified electronic health records from the TriNetX network covering 2005 through 2025 and compared patients treated in a peri-event window with matched patients whose injections were paused. The authors analyzed 1,526 matched pairs in the stroke cohort and 1,523 matched pairs in the myocardial infarction cohort. JAMA Ophthalmology’s key-point summary said peri-event treatment was not associated with worse mortality or morbidity outcomes, and it found no differences among aflibercept, bevacizumab and ranibizumab. ### Which patients were included in the analysis? The study population consisted of patients with an established anti-VEGF history of at least three months before a cardiovascular event, according to the JAMA Ophthalmology abstract. The investigators examined patients who had a stroke or myocardial infarction and compared those who received one or more injections within 14 days before or up to six weeks after the event with those who received no anti-VEGF from three months before to three months after. TriNetX records from 2005 to 2025 formed the data set for the retrospective cohort study. Medical Dialogues, summarizing the paper, said the matched analysis covered more than 3,000 paired observations across the stroke and heart attack groups after propensity-score matching. (jamanetwork.com) ### What did the study find after stroke? JAMA Ophthalmology said peri-event anti-VEGF treatment in the stroke cohort was not associated with worse mortality or morbidity outcomes. The journal’s invited commentary by Igor Kozak said anti-VEGF exposure after stroke was associated with lower all-cause mortality at 90 days and one year compared with matched controls who did not receive an injection. (jamanetwork.com) Kozak wrote that the stroke cohort also showed a lower incidence of residual neurologic deficits at 90 days, but not at one year. That commentary described the findings as results from a multicenter, retrospective electronic health record study rather than a randomized trial. (jamanetwork.com) ### What did the study find after myocardial infarction? The myocardial infarction cohort also showed no signal of worse outcomes with continued injections, according to the JAMA Ophthalmology key points. Kozak wrote that peri-MI anti-VEGF exposure was associated with lower all-cause mortality at 90 days and one year and with a lower incidence of heart failure at 90 days. (jamanetwork.com) Medical Dialogues reported that the heart-failure difference was less apparent by one year and that mortality findings remained consistent when the analysis narrowed exposure to injections given strictly within 14 days before the cardiovascular event. That account tracked with the paper’s focus on timing around the event. (jamanetwork.com) ### Did outcomes differ by the specific anti-VEGF drug? JAMA Ophthalmology said no differences were identified among the commonly used anti-VEGF agents aflibercept, bevacizumab and ranibizumab. The journal’s key-point summary said those comparisons covered data from 2005 through 2025. (jamanetwork.com) Medical Dialogues said the study found no meaningful differences across those agents, describing the safety profile as similar across treatment options examined in the analysis. ### How did outside commentary frame the findings? (medicaldialogues.in) Igor Kozak of the University of Arizona wrote in an invited commentary published the same day that Bordbar and colleagues addressed a practical question about whether anti-VEGF injections should be paused or modified after a recent stroke or myocardial infarction. Kozak summarized the main results as lower mortality signals in both cohorts and no difference among specific anti-VEGF agents. (jamanetwork.com) The commentary did not convert the study into a clinical directive. It presented the findings as observational evidence from a multicenter electronic health record analysis published alongside the original investigation. (medicaldialogues.in) ### Where can readers find the primary report? The original investigation, “Peri-Event Intravitreal Anti-VEGF and Systemic Outcomes After Stroke or Myocardial Infarction,” was published online March 26, 2026 in JAMA Ophthalmology with DOI 10.1001/jamaophthalmol.2026.0460. The invited commentary, “Continuing Intravitreal Anti-VEGF After Recent Stroke or MI,” by Igor Kozak was published online the same day in the same journal. (jamanetwork.com 1) (jamanetwork.com 2)