Subclinical Coronary Atherosclerosis and Retinal Optical Coherence Tomography Angiography.

IF 14.1 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Jee Myung Yang,Dong Hyun Yang,Seung-Whan Lee,Jiehoon Kwak,Yunhan Lee,Yoon Jeon Kim,Joo Yong Lee,Kyung Rim Sung,Young Hee Yoon
{"title":"Subclinical Coronary Atherosclerosis and Retinal Optical Coherence Tomography Angiography.","authors":"Jee Myung Yang,Dong Hyun Yang,Seung-Whan Lee,Jiehoon Kwak,Yunhan Lee,Yoon Jeon Kim,Joo Yong Lee,Kyung Rim Sung,Young Hee Yoon","doi":"10.1001/jamacardio.2025.3036","DOIUrl":null,"url":null,"abstract":"Importance\r\nSystemic disease burden is well reflected in the retinal microvasculature, but it is not established whether optical coherence tomography angiography (OCTA) parameters can reliably reflect coronary atherosclerosis.\r\n\r\nObjective\r\nTo assess the association of reduced retinal vascular density and subclinical coronary atherosclerosis in asymptomatic individuals.\r\n\r\nDesign, Setting, and Participants\r\nThis cross-sectional cohort study included asymptomatic individuals with elevated cardiovascular risk who self-referred for a health screening program involving coronary computed tomography angiography (CTA) at Asan Medical Center in Seoul, South Korea, and subsequently underwent OCTA as part of ophthalmic evaluations. This study was conducted from October 2015 to December 2020, and data analysis was conducted from January 2021 to May 2025.\r\n\r\nMain Outcomes and Measures\r\nThe primary outcome was the association between OCTA parameters and coronary CTA parameters.\r\n\r\nResults\r\nA total of 1286 eyes from 1286 participants were analyzed (mean [SD] age, 64.2 [9.9] years; 482 female participants [37.5%]). Coronary artery calcium score (CACS), presence of plaque and its subtypes, obstructive coronary artery disease (CAD), severe CAD, segment stenosis score (SSS), and segment involvement score (SIS) were significantly increased across the quartiles of superficial and deep parafoveal vascular density (PFVD). When modeled as continuous variables, superficial capillary plexus (SCP) and deep capillary plexus (DCP) PFVD were the most significant metrics and correlated with CACS, number of coronary vessels involved, SSS, and SIS. The lowest quartile of SCP PFVD was associated with significantly higher odds of obstructive CAD (adjusted odds ratio [aOR], 2.91; 95% CI, 1.83-4.73), severe CAD (aOR, 3.30; 95% CI, 1.55-7.91), and elevated SSS and SIS scores compared to the highest quartile. Similar but attenuated associations were observed for DCP PFVD. Continuous variable analysis for ORs for unit increase supported a linear inverse association between PFVD and CAD burden. Incorporating PFVD into models with cardiovascular risk factors improved area under the curve (AUC) for identifying severe CAD (AUC, 0.79; 95% CI, 0.75-0.82), obstructive CAD (AUC, 0.78; 95% CI, 0.76-0.81), and SSS of 10 or higher (AUC, 0.77; 95% CI, 0.74-0.80), with SCP yielding superior performance over DCP.\r\n\r\nConclusions and Relevance\r\nIn this cross-sectional cohort study, reduced retinal PFVD was independently associated with subclinical coronary atherosclerosis in a population with elevated vascular risk. In this context, decreased PFVD may reflect greater subclinical coronary atherosclerotic burden and help identify individuals who could benefit from further coronary evaluation, beyond traditional risk factors.","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"83 1","pages":""},"PeriodicalIF":14.1000,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JAMA cardiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1001/jamacardio.2025.3036","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0

Abstract

Importance Systemic disease burden is well reflected in the retinal microvasculature, but it is not established whether optical coherence tomography angiography (OCTA) parameters can reliably reflect coronary atherosclerosis. Objective To assess the association of reduced retinal vascular density and subclinical coronary atherosclerosis in asymptomatic individuals. Design, Setting, and Participants This cross-sectional cohort study included asymptomatic individuals with elevated cardiovascular risk who self-referred for a health screening program involving coronary computed tomography angiography (CTA) at Asan Medical Center in Seoul, South Korea, and subsequently underwent OCTA as part of ophthalmic evaluations. This study was conducted from October 2015 to December 2020, and data analysis was conducted from January 2021 to May 2025. Main Outcomes and Measures The primary outcome was the association between OCTA parameters and coronary CTA parameters. Results A total of 1286 eyes from 1286 participants were analyzed (mean [SD] age, 64.2 [9.9] years; 482 female participants [37.5%]). Coronary artery calcium score (CACS), presence of plaque and its subtypes, obstructive coronary artery disease (CAD), severe CAD, segment stenosis score (SSS), and segment involvement score (SIS) were significantly increased across the quartiles of superficial and deep parafoveal vascular density (PFVD). When modeled as continuous variables, superficial capillary plexus (SCP) and deep capillary plexus (DCP) PFVD were the most significant metrics and correlated with CACS, number of coronary vessels involved, SSS, and SIS. The lowest quartile of SCP PFVD was associated with significantly higher odds of obstructive CAD (adjusted odds ratio [aOR], 2.91; 95% CI, 1.83-4.73), severe CAD (aOR, 3.30; 95% CI, 1.55-7.91), and elevated SSS and SIS scores compared to the highest quartile. Similar but attenuated associations were observed for DCP PFVD. Continuous variable analysis for ORs for unit increase supported a linear inverse association between PFVD and CAD burden. Incorporating PFVD into models with cardiovascular risk factors improved area under the curve (AUC) for identifying severe CAD (AUC, 0.79; 95% CI, 0.75-0.82), obstructive CAD (AUC, 0.78; 95% CI, 0.76-0.81), and SSS of 10 or higher (AUC, 0.77; 95% CI, 0.74-0.80), with SCP yielding superior performance over DCP. Conclusions and Relevance In this cross-sectional cohort study, reduced retinal PFVD was independently associated with subclinical coronary atherosclerosis in a population with elevated vascular risk. In this context, decreased PFVD may reflect greater subclinical coronary atherosclerotic burden and help identify individuals who could benefit from further coronary evaluation, beyond traditional risk factors.
亚临床冠状动脉粥样硬化和视网膜光学相干断层血管造影。
全身性疾病负担可以很好地反映在视网膜微血管中,但光学相干断层扫描血管造影(OCTA)参数是否能可靠地反映冠状动脉粥样硬化尚未确定。目的探讨无症状患者视网膜血管密度降低与亚临床冠状动脉粥样硬化的关系。设计、环境和参与者本横断面队列研究纳入了无症状且心血管风险升高的个体,这些个体在韩国首尔牙山医疗中心接受了包括冠状动脉计算机断层血管造影(CTA)在内的健康筛查项目,随后接受了OCTA作为眼科评估的一部分。本研究时间为2015年10月至2020年12月,数据分析时间为2021年1月至2025年5月。主要结局和测量主要结局是OCTA参数和冠状动脉CTA参数之间的相关性。结果1286名受试者共1286只眼(平均[SD]年龄64.2[9.9]岁,其中女性482只[37.5%])。冠状动脉钙化评分(CACS)、斑块及其亚型的存在、阻塞性冠状动脉疾病(CAD)、严重冠心病、节段狭窄评分(SSS)和节段受累评分(SIS)在浅浅和深凹旁血管密度(PFVD)的四分位数上均显著升高。当建模为连续变量时,浅毛细血管丛(SCP)和深毛细血管丛(DCP) PFVD是最显著的指标,并与CACS、冠状动脉受累数、SSS和SIS相关。与最高四分位数相比,SCP PFVD的最低四分位数与阻塞性CAD(校正优势比[aOR], 2.91; 95% CI, 1.83-4.73)、严重CAD (aOR, 3.30; 95% CI, 1.55-7.91)、SSS和SIS评分升高的几率显著升高相关。在DCP PFVD中观察到类似但减弱的关联。对单位增加的or的连续变量分析支持PFVD和CAD负担之间的线性负相关。将PFVD纳入具有心血管危险因素的模型中,可提高识别严重CAD (AUC, 0.79; 95% CI, 0.75-0.82)、阻塞性CAD (AUC, 0.78; 95% CI, 0.76-0.81)和SSS为10或更高(AUC, 0.77; 95% CI, 0.74-0.80)的曲线下面积(AUC),其中SCP优于DCP。结论和相关性在这项横断面队列研究中,在血管风险升高的人群中,视网膜PFVD减少与亚临床冠状动脉粥样硬化独立相关。在这种情况下,减少的PFVD可能反映出更大的亚临床冠状动脉粥样硬化负担,并有助于识别那些可以从进一步的冠状动脉评估中受益的个体,而不是传统的危险因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
JAMA cardiology
JAMA cardiology Medicine-Cardiology and Cardiovascular Medicine
CiteScore
45.80
自引率
1.70%
发文量
264
期刊介绍: JAMA Cardiology, an international peer-reviewed journal, serves as the premier publication for clinical investigators, clinicians, and trainees in cardiovascular medicine worldwide. As a member of the JAMA Network, it aligns with a consortium of peer-reviewed general medical and specialty publications. Published online weekly, every Wednesday, and in 12 print/online issues annually, JAMA Cardiology attracts over 4.3 million annual article views and downloads. Research articles become freely accessible online 12 months post-publication without any author fees. Moreover, the online version is readily accessible to institutions in developing countries through the World Health Organization's HINARI program. Positioned at the intersection of clinical investigation, actionable clinical science, and clinical practice, JAMA Cardiology prioritizes traditional and evolving cardiovascular medicine, alongside evidence-based health policy. It places particular emphasis on health equity, especially when grounded in original science, as a top editorial priority.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信