A novel algorithm for cardiovascular screening using conjunctival microcirculatory parameters and blood biomarkers

Area of Science:

• Ophthalmology
• Cardiology
• Medical Diagnostics

Background:

• Microvascular haemodynamic alterations are linked to coronary artery disease (CAD).
• The conjunctival microcirculation offers a non-invasive assessment method.
• Previous studies have not explored conjunctival microcirculation for CAD identification algorithms.

Purpose of the Study:

• To investigate the utility of conjunctival microcirculation in identifying patients with CAD.
• To develop and evaluate a novel algorithm for CAD screening using conjunctival haemodynamics and biomarkers.

Main Methods:

• A case-control study involving 66 post-myocardial infarction patients and 66 healthy controls.
• Assessment of conjunctival microcirculation haemodynamics using an iPhone and slit lamp imaging tool.
• Analysis of haemodynamic properties with semi-automated software and comparison between groups.
• Integration of conjunctival parameters with biomarkers (N-terminal pro-brain natriuretic peptide, adiponectin).

Main Results:

• The developed algorithm, combining conjunctival blood velocity and biomarkers, achieved an AUROC of 0.967.
• The algorithm demonstrated high sensitivity (93.0%) and specificity (91.5%) for detecting CAD.
• Conjunctival microcirculatory parameters and specific blood biomarkers were significant predictors.

Conclusions:

• A novel algorithm integrating conjunctival haemodynamics and blood biomarkers shows potential as a non-invasive screening tool for CAD.
• This approach could be valuable for early detection, particularly in asymptomatic individuals.
• Further validation is recommended for clinical utility in broader populations.