Retinopathy signs independently associated with coronary artery calcification

Microvascular disease may be directly involved in the pathogenesis of coronary heart disease, and was shown to predict coronary heart disease. It is still unclear whether retinal vascular changes are associated with subclinical coronary artery disease. In this population-based multi-ethnic study, 6147 subjects aged 45-84 years, and free of clinical cardiovascular disease, were sampled from six US communities in 2002-2004. Coronary artery calcification (CAC), a subclinical coronaropathy surrogate and independent predictor of future coronary events, was assessed by cardiac computed tomography scanning and categorized into three groups of severity: none (score=0), mild (1-100), and moderate-to-severe (>100). Retinopathy signs and retinal vascular calibre were graded from retinal photographs following standardized protocols. After adjusting for standard risk factors, retinopathy was associated with moderate-to-severe CAC score. This association remained significant in both men and women and in subjects with or without diabetes or hypertension. Variations in retinal vascular calibre were not significantly associated with CAC score. Based on these results, the authors conclude that retinopathy signs are independently associated with CAC, supporting the concept that common pathophysiologic processes may underlie both micro- and macrovascular changes.

Abstract

Keywords:
Coronary artery disease – Diabetes – Hypertension – Macrovascular disease – Microvascular disease – Retinopathy