The risk of acute coronary syndrome after retinal artery occlusion: a population-based cohort study

Chang, Yuh‐Shin; Chu, Cordia Ming-Yeuk; Weng, Shih‐Feng; Chang, Chi-Lung; Wang, Jhi‐Joung; Jan, Ren‐Long

doi:10.1136/bjophthalmol-2014-305451

Cited by 45 publications

(56 citation statements)

References 28 publications

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“…Furthermore, several studies have reported that the incidence of stroke and acute coronary syndrome is significantly high following RAO events. 8,39 This suggests that ESRD patients with hypertension should be considered for cardiovascular monitoring to ameliorate RAO and prevent stroke.…”

Section: Discussionmentioning

confidence: 99%

Risk of Retinal Artery Occlusion in Patients With End-Stage Renal Disease

et al. 2016

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There is globally increasing prevalence and incidence in end-stage renal disease (ESRD). These patients are frequently reported to have retinal abnormalities and both diseases share some systemic risk factors. Hence, it is clinically relevant to determine whether ESRD is a predictor of retinal artery occlusion (RAO).To investigate the risk of RAO in ESRD patients.A retrospective, nationwide, matched cohort study. The study included 93,766 ESRD patients recruited between 2000 and 2009 from the Taiwan National Health Insurance Research Database. The same number control group included age- and sex-matched patients without ESRD selected from the Taiwan Longitudinal Health Insurance Database, 2000. Data for each patient were collected from the index date until December 2011.The incidence and risk of RAO were compared between the 2 groups. The hazard ratio (HR) for RAO after adjustment for potential confounders was calculated using Cox proportional hazards regression. Kaplan–Meier analysis was used to calculate the cumulative RAO incidence rate.In total, 237 ESRD patients and 73 controls exhibited RAO during follow-up; thus, the RAO incidence rate in ESRD patients was 4.49 times (95% confidence interval (CI), 3.45–5.83) that in the control patients. After adjustment for potential confounders, including diabetes mellitus, hypertension, hyperlipidemia, congestive heart failure, and coronary artery disease, ESRD patients were 2.78 times (95% CI, 2.02–3.84) more likely to develop RAO in cohort for the total sample. Among patients with hypertension, the RAO incidence rate was significantly higher in the ESRD group, and hypertension significantly increased RAO risk even after adjustment for other confounders in the cohort.ESRD increases the risk of RAO, particularly in ESRD patients with hypertension. Therefore, clinicians should educate ESRD patients about RAO and ensure appropriate blood pressure control.

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Section: Discussionmentioning

confidence: 99%

Risk of Retinal Artery Occlusion in Patients With End-Stage Renal Disease

et al. 2016

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“…Multiple studies show that RAO is a predictor of ACS, stroke, and mortality [1,2,7]. Chang et al showed a 70% increase in the risk of ACS in patients with RAO, and even higher in patients with central retinal artery occlusion (CRAO) [1]. In 2012, the same authors reported that RAO increased the risk of stroke by a factor of 2.07, and the risk was increased more than threefold in patients below 60 years of age [2].…”

Section: Discussionmentioning

confidence: 86%

“…Risk factors for RAO include hypercholesterolemia, hypertension, carotid artery and aortic arch atherosclerosis, ischemic heart disease, kidney dysfunction, diabetes, stroke, smoking, mitral and aortic valve disease, and thrombi or vegetations which might be a source of embolic material [8,10]. Multiple studies show that RAO is a predictor of ACS, stroke, and mortality [1,2,7]. Chang et al showed a 70% increase in the risk of ACS in patients with RAO, and even higher in patients with central retinal artery occlusion (CRAO) [1].…”

Section: Discussionmentioning

confidence: 99%

“…The major cause of RAO is carotid artery and aortic arch atherosclerosis, and less frequent causes include mitral and aortic valve disease, infective endocarditis, coagulopathies, atrial fibrillation, and autoimmune diseases including giant cell arteritis. Population studies indicate that RAO is associated with increased acute coronary syndrome (ACS) and stroke rates [1,2]. Incident RAO in patients with atrial fibrillation is associated with an increased thromboembolic risk [3].…”

Section: Introductionmentioning

confidence: 99%

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Czynniki ryzyka sercowo-naczyniowego w grupie 100 pacjentów z zatorem tętnic siatkówki — rejestr jednoośrodkowy

et al. 2017

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Lekarz Joanna Roskal-Wałek jest absolwentką Wydziału Lekarskiego Uniwersytetu Medycznego w Lublinie. Obecnie odbywa szkolenie specjalizacyjne z okulistyki w Klinice Okulistyki Wojewódzkiego Szpitala Zespolonego w Kielcach pod kierownictwem dr n. med. Magdaleny Gierady. Do kręgu zainteresowań medycznych dr Roskal-Wałek należą choroby siatkówki, głównie te pochodzenia naczyniowego. Wolny czas poświęca na podróże i taniec. AbstractIntroduction. The aim of the study was to evaluate cardiovascular risk factors in patients after retinal artery occlusion (RAO). Additionally, our findings were compared with the results of epidemiological studies on the prevalence of cardiovascular risk factors in the Polish population. Material and methods. We conducted a retrospective study which involved a group of 100 patients admitted to the ophthalmology service due to RAO in 2004RAO in -2014. Results. In our study group, hypertension was found in 78% of patients, hypercholesterolemia in 67% of patients, ischemic heart disease in 53% of patients, previous myocardial infarction in 20% of patients, heart failure in 17% of patients, diabetes type 2 in 16% of patients, atrial fibrillation in 14% of patients, and kidney dysfunction in 11% of patients. Twelve percent of patients had a history of stroke, and 31% were smokers. Doppler ultrasonography (USG) showed carotid atherosclerotic plaques in 78% of patients and ≥ 70% carotid artery stenosis in 33% of patients. Transthoracic echocardiography revealed aortic valve calcifications in 63% of patients. Conclusions. Cardiovascular risk factors are present in a large majority of patients with RAO. Compared to the general population, patients with RAO often suffer from hypertension, hypercholesterolemia, type 2 diabetes and renal dysfunction. Due to an association between RAO and cardiovascular risk factors, appropriate diagnostic work-up is of major importance in these patients. Basic investigations in patients after a RAO event should include carotid artery Doppler ultrasound, echocardiography, electrocardiography, blood pressure measurement, and laboratory tests

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“…Several previous studies using the same database have been published. 32,33 Thus, selection bias in referral centers and chances of misdiagnosis may be reduced. The NHI Research Database contains all claims data, thereby ensuring accuracy and avoiding recall bias because data are recorded electronically.…”

Section: Discussionmentioning

confidence: 99%