TY - JOUR
T1 - Associations between retinal microvascular structure and the severity and extent of coronary artery disease
AU - Gopinath, Bamini
AU - Chiha, Joseph
AU - Plant, Adam J. H.
AU - Thiagalingam, Aravinda
AU - Burlutsky, George
AU - Kovoor, Pramesh
AU - Liew, Gerald
AU - Mitchell, Paul
PY - 2014/9
Y1 - 2014/9
N2 - Microvascular mechanisms are increasingly recognized as being involved in a significant proportion of coronary artery disease (CAD) cases, but their exact contribution or role is unclear. We aimed to define the association between retinal microvascular signs and both CAD extent and severity. Methods: 1120 participants of the Australian Heart Eye Study were included. Retinal vessel caliber was measured from digital retinal images. Extent and severity of CAD was assessed using several approaches. First, a simple scoring classifying participants as having one-vessel, two-vessel, and three-vessel disease was used. Gensini and Extent scores were calculated using angiography findings. Results: After multivariable adjustment, significantly narrower retinal arteriolar caliber in women (comparing lowest versus highest quartile or reference) and wider venular caliber in men (comparing highest versus lowest quartile or reference) were associated with 2-fold and 54% higher odds of having at least one stenosis ≥50% in the epicardial coronary arteries, respectively. Women in the third versus first tertile of retinal venular caliber had 92% and ~2-fold higher likelihood of having higher Gensini and Extent scores, respectively. Women in the lowest versus highest tertile of retinal arteriolar caliber had greater odds of having higher Extent scores, OR 2.99 (95% CI 1.45-6.16). In men, non-significant associations were observed between retinal vascular caliber and Gensini and Extent scores. Conclusions: An unhealthy retinal microvascular profile, namely, narrower retinal arterioles and wider venules was associated with more diffuse and severe CAD among women.
AB - Microvascular mechanisms are increasingly recognized as being involved in a significant proportion of coronary artery disease (CAD) cases, but their exact contribution or role is unclear. We aimed to define the association between retinal microvascular signs and both CAD extent and severity. Methods: 1120 participants of the Australian Heart Eye Study were included. Retinal vessel caliber was measured from digital retinal images. Extent and severity of CAD was assessed using several approaches. First, a simple scoring classifying participants as having one-vessel, two-vessel, and three-vessel disease was used. Gensini and Extent scores were calculated using angiography findings. Results: After multivariable adjustment, significantly narrower retinal arteriolar caliber in women (comparing lowest versus highest quartile or reference) and wider venular caliber in men (comparing highest versus lowest quartile or reference) were associated with 2-fold and 54% higher odds of having at least one stenosis ≥50% in the epicardial coronary arteries, respectively. Women in the third versus first tertile of retinal venular caliber had 92% and ~2-fold higher likelihood of having higher Gensini and Extent scores, respectively. Women in the lowest versus highest tertile of retinal arteriolar caliber had greater odds of having higher Extent scores, OR 2.99 (95% CI 1.45-6.16). In men, non-significant associations were observed between retinal vascular caliber and Gensini and Extent scores. Conclusions: An unhealthy retinal microvascular profile, namely, narrower retinal arterioles and wider venules was associated with more diffuse and severe CAD among women.
KW - Australian heart eye study
KW - coronary artery disease
KW - retinal vessel caliber
KW - Gensini score
KW - extent score
UR - http://www.scopus.com/inward/record.url?scp=84905815977&partnerID=8YFLogxK
U2 - 10.1016/j.atherosclerosis.2014.06.018
DO - 10.1016/j.atherosclerosis.2014.06.018
M3 - Article
C2 - 25010900
VL - 236
SP - 25
EP - 30
JO - Atherosclerosis
JF - Atherosclerosis
SN - 0021-9150
IS - 1
ER -