Abstract | BACKGROUND: Narrower retinal arterioles and wider retinal venules have been associated with negative cardiovascular outcomes. We investigated whether retinal vessel calibers are associated with cardiovascular outcomes in long-term follow-up and provide incremental value over the 2013 American College of Cardiology/American Heart Association Pooled Cohort Equations in predicting atherosclerotic cardiovascular disease events. METHODS: RESULTS: During a mean follow-up of 16 years, there were 1779 incident coronary heart disease events, 548 ischemic strokes, 1395 heart failure events, and 2793 deaths. Rates of all outcomes were higher in those with wider retinal venules and narrower retinal arterioles. Subjects with wider retinal venules (hazard ratio [HR], 1.13; 95% confidence interval [CI], 1.08-1.18; HR, 1.18; 95% CI, 1.07-1.31; and HR, 1.10; 95% CI, 1.00-1.20 per 1-SD increase) and narrower retinal arterioles (HR, 1.06; 95% CI, 1.01-1.11; HR, 1.14; 95% CI, 1.03-1.26; and HR, 1.13; 95% CI, 1.03-1.24 per 1-SD decrease) had a higher risk of death and stroke in both sexes and incident coronary heart disease in women but not men (interaction P=0.02) after adjustment for the Pooled Cohort Equations risk score variables. The association between retinal vessel caliber and heart failure was nonsignificant after adjustment for systolic blood pressure. Among women with Pooled Cohort Equations-predicted 10-year atherosclerotic cardiovascular disease event risk <5% (overall risk, 3.9%), women in the narrowest arteriolar quartile had a 10-year event rate of 5.6% compared with 2.8% for women in the widest quartile (5.0% versus 3.4% for wider versus narrower venules). Retinal vessel caliber reclassified 21% of low-risk women (11% of all women) as intermediate risk (>5%). CONCLUSIONS:
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Authors | Sara B Seidelmann, Brian Claggett, Paco E Bravo, Ankur Gupta, Hoshang Farhad, Barbara E Klein, Ronald Klein, Marcelo Di Carli, Scott D Solomon |
Journal | Circulation
(Circulation)
Vol. 134
Issue 18
Pg. 1328-1338
(Nov 01 2016)
ISSN: 1524-4539 [Electronic] United States |
PMID | 27682886
(Publication Type: Clinical Trial, Journal Article, Multicenter Study, Observational Study)
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Copyright | © 2016 American Heart Association, Inc. |
Chemical References |
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Topics |
- Adult
- Atherosclerosis
(complications, mortality, pathology, physiopathology)
- Biomarkers
- Brain Ischemia
(etiology, mortality, pathology, physiopathology)
- Coronary Disease
(complications, mortality, pathology, physiopathology)
- Female
- Follow-Up Studies
- Humans
- Male
- Prospective Studies
- Retinal Artery
(pathology, physiopathology)
- Risk Factors
- Stroke
(etiology, mortality, pathology, physiopathology)
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