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RETINAL MICROVASCULAR CHANGES AND RISK OF CORONARY HEART DISEASE: A Systematic Review and Meta-Analysis
Wenyi Zhang1, Xinying Guo, Xue Jiang
1Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China.
Insights
Retinal microvascular changes like narrowing and widening are linked to a higher risk of coronary heart disease (CHD). These changes may signal future heart issues, especially in women and younger individuals.
Area of Science:
- Ophthalmology and Cardiology
- Vascular Biology
- Public Health
Background:
- Coronary heart disease (CHD) is a leading cause of mortality worldwide.
- Retinal microvascular changes are potential early indicators of systemic vascular disease.
- Understanding the link between retinal signs and CHD risk can improve cardiovascular screening.
Approach:
- A comprehensive meta-analysis was conducted, synthesizing data from 21 cohort studies.
- Searches included major databases (PubMed, Embase, Web of Science, Cochrane) up to July 2023.
- Random-effects models and subgroup analyses were employed to ensure robust findings.
Key Points:
- Significant associations were found between various retinal microvascular changes (arteriolar narrowing, venular widening, vessel occlusion) and increased CHD risk (HR 1.20).
- Retinal vascular abnormalities were particularly associated with higher CHD risk in female patients and younger adults.
- These findings highlight the potential of noninvasive retinal assessments for CHD risk stratification.
Conclusions:
- Retinal microvascular abnormalities serve as important indicators for future coronary heart disease development.
- The association is pronounced in specific demographics, including females and younger individuals.
- Integrating retinal imaging into routine health screenings could enhance early detection and prevention of CHD.
Purpose:
To quantify associations between various retinal microvascular changes and the risk of the development of coronary heart disease (CHD).
Methods:
PubMed, Embase, Web of Science, and Cochrane Library databases were searched for cohort studies on the association between retinal microvascular changes and incident CHD up to July 31, 2023. The summary risk estimates were estimated using the random-effects model. Subgroup and sensitivity analyses were performed to investigate the potential source of heterogeneity.
Results:
The authors identified 21 studies that met the inclusion criteria of this meta-analysis through database searching. This study yielded significant associations between retinal microvascular changes, including arteriolar narrowing, venular widening, vessel occlusion, and other retinal vascular signs, and the risk of CHD, with pooled adjusted hazard ratios of 1.20 (95% confidence interval: 1.13-1.27). In sex- and age-stratified analyses, retinal microvascular changes were associated with a greater risk of developing CHD in female patients and younger adults.
Conclusion:
A range of retinal microvascular changes was associated with the risk of CHD, particularly in female patients and younger ages. The results of this study support the concept that retinal microvascular abnormalities may be markers for future CHD. Noninvasive retinal microvascular assessments may be helpful in screening patients with increased CHD risk.
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