Vascular retinopathy and relationship with long-term development of ischemic heart disease. Results of the RETICARD registry

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Despite the undoubted relationship between retinopathy and cardiovascular pathology, its role as a predictor in the development of myocardial ischemia has not been sufficiently studied. Methodology Prospective study of a Spanish cohort of 107 patients who underwent diagnostic-therapeutic coronary angiography by medical indication. A fundus examination was also performed, determining the existence of retinopathy of vascular etiology (diabetic, hypertensive or atherosclerotic) and classifying it according to its degree. During follow-up, the appearance of myocardial perfusion defects was recorded by gated-SPECT. Results The median age was 67 years. 60.7% were men. The mean follow-up time was 111±19.7 months. Of the patients, 91.6% had some cardiovascular risk factor: 32.7% were diabetic, 78.5% had hypertension and 57% had dyslipidemia. 91.6% of the patients had some cardiovascular risk factor: 32.7% were diabetic, 78.5% had hypertension and 57% had dyslipidemia. 84.1% of the patients, had retinopathy of vascular etiology, 43.6% of whom had high-grade retinopathy. Significant coronary artery disease was present in 44.9%, with a mean SYNTAX score of 3.99±7.5 and 39.3% required percutaneous intervention. During follow-up, 15% presented inducible ischemia assessed by gated-SPECT. Subsequent coronary angiography was performed in 68.8% of these cases. Advanced vascular retinopathy, male sex, SYNTAX score and previous percutaneous coronary intervention were associated with a higher risk of myocardial perfusion defects. In logistic regression adjusted for these variables, vascular retinopathy presented an OR of 5.3 (95%CI 0.9-30.6; p=0.063) for the development of myocardial ischemia. Conclusion The presence of high-grade vascular retinopathy is an independent risk marker for the development of myocardial ischemia assessed by SPECT. Performing a funduscopic examination as part of the stratification of the cardiovascular patient could allow us to identify patients at higher risk.