Xanthelasma and its association with developing major cardio-cerebrovascular events

To evaluate short- and long-term incidence of major adverse cardio-cerebrovascular events (MACCEs) in patients with xanthelasma.

Using TriNetX, an aggregated electronic health-records network, we identified adults with xanthelasma and matched controls with presbyopia without xanthelasma. Patients with a history of myocardial infarction (MI), ST-elevation/non-ST-elevation MI, stroke, and transient ischemic attack (TIA) any time prior to diagnosis were excluded in both cohorts. Cohorts were matched 1:1 by propensity scores, and MACCEs were compared at 1-, 5-, and 10-years. A Kaplan-Meier was evaluated with the log-rank test based on the incidence of MACCEs.

After PSM, there were a total of 17,925 patients with at least 12 months of follow-up in each cohort. At 1 year, xanthelasma was associated with higher incidence of MI (1.00% vs 0.35%; hazard ratio (HR) 2.92, 95% confidence interval (CI): 2.20, 3.90), stroke (0.95% vs 0.30%; HR 3.35, 95% CI: 2.44-4.52), and TIA (0.60% vs 0.19%; HR 3.29, 95% CI: 2.24, 4.84). At 5 years, MI (2.26% vs 1.13%; HR 2.24, 95% CI: 1.89, 2.65), stroke (2.25% vs 1.03%; HR 2.46, 95% CI: 2.06, 2.93), and TIA (1.60% vs 0.74%; HR 2.41, 95% CI: 1.96, 2.97) remained high. At 10 years, MI (3.13% vs 1.73%; HR 2.14, 95% CI: 1.85, 2.45), stroke (3.00% vs 1.53%; HR 2.32, 95% CI: 2.00, 2.70), and TIA (2.00% vs 1.13%; HR 2.10, 95% CI: 1.75, 2.50) remained elevated. All comparisons were statistically significant (p < 0.0001).

Xanthelasma is associated with higher short- and long-term incidence of MACCEs up to 10 years, highlighting its value as a clinical marker for cardiocerebrovascular risk stratification and preventive management.