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Calibres de vasos retinianos en la predicción de resultados cardiovasculares a largo plazo: el estudio de riesgo de

Sara B Seidelmann¹, Brian Claggett¹, Paco E Bravo¹

¹From Cardiovascular Division (S.B.S, B.D., P.E.G., A.G., H.F., M.D.C., S.D.S.) and Department of Radiology, Division of Cardiovascular Imaging (S.B.S, P.E.G., A.G., H.F., M.D.C.), Brigham and Women's Hospital, Boston, MA; and Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health University of Wisconsin, Madison (B.E.K., R.K.).

|September 30, 2016

Resumen

El calibre de los vasos retinianos, específicamente las arteriolas más estrechas y las vénulas más anchas, predice el riesgo cardiovascular a largo plazo. Este biomarcador barato mejora la evaluación del riesgo, especialmente para las mujeres, al identificar a las personas que necesitan un monitoreo más cercano para la enfermedad cardiovascular aterosclerótica.

Área de la Ciencia:

Oftalmología
Cardiología
Salud pública

Sus antecedentes:

Los cambios en la microvasculatura de la retina, incluidas las arteriolas más estrechas y las vénulas más anchas, están relacionados con resultados cardiovasculares adversos.
Los modelos de predicción de riesgo existentes para la enfermedad cardiovascular aterosclerótica (ASCVD, por sus siglas en inglés) pueden no captar completamente todos los factores de riesgo.

Objetivo del estudio:

Investigar la asociación entre los calibres de los vasos retinianos y los resultados cardiovasculares a largo plazo.
Para determinar si el calibre de los vasos de la retina proporciona un valor predictivo incremental más allá de las ecuaciones de cohorte combinadas del Colegio Americano de Cardiología / Asociación Americana del Corazón (PCE) de 2013.

Principales métodos:

La fotografía de retina se realizó en 10.470 participantes en el Estudio de Riesgo de Aterosclerosis en Comunidades (ARIC) sin eventos previos de ASCVD o insuficiencia cardíaca.
Los participantes fueron seguidos durante una media de 16 años para determinar la incidencia de enfermedad coronaria, accidente cerebrovascular isquémico, insuficiencia cardíaca y mortalidad.

Principales resultados:

Las vénulas retinianas más anchas y las arteriolas retinianas más estrechas se asociaron con un mayor riesgo de mortalidad, accidente cerebrovascular isquémico y enfermedad coronaria (en las mujeres).
El calibre de los vasos retinianos reclasificó al 21% de las mujeres clasificadas inicialmente como de bajo riesgo por PCE a una categoría de riesgo intermedio.
Las asociaciones con la insuficiencia cardíaca no fueron significativas después de ajustar la presión arterial sistólica.

Conclusiones:

Las arteriolas retinianas más estrechas y las venulas retinianas más anchas son predictores independientes a largo plazo de mortalidad, accidente cerebrovascular isquémico y enfermedad coronaria (en mujeres).
El calibre de los vasos retinianos es un biomarcador barato y reproducible que mejora la predicción del riesgo de ASCVD, especialmente en mujeres de bajo riesgo.
Estos hallazgos apoyan la integración de la evaluación del calibre de los vasos retinianos en la evaluación rutinaria del riesgo cardiovascular.

Palabras clave:

Enfermedades cardiovasculares el fallecimiento el golpe las mujeres

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