Key result
Atrial fibrillation is linked to ~8.3-fold higher risk of developing retinal artery occlusion.
Why the study?
The roles and relative contributions of atrial fibrillation and coronary artery disease as risk factors for retinal artery occlusion were unclear.
Cohort (n=239,468)
AF and CAD were associated with higher retinal artery occlusion risk; hypothesis-generating for screening or prevention trials.
We use Taiwanese national health insurance research database (NHIRD) to investigate whether thrombolism (carotid artery disease (CAD) as a surrogate) or embolism (atrial fibrillation (AF) as a surrogate) plays roles in later retinal artery occlusion (RAO) development and examine their relative weights. The relative risks of RAO between AF and CAD patients and controls were compared by estimating the crude hazard ratio with logistic regression. Kaplan-Meier analysis was used to calculate the cumulative incidence rates of developing RAO, and a log-rank test was used to analyze the differences between the survival curves. Separate Cox proportional hazard regressions were done to compute the RAO-free rate after adjusting for possible confounding factors such as age and sex. The crude hazard ratios were 7.98 for the AF group and 5.27 for the CAD group, and the adjusted hazard ratios were 8.32 and 5.34 for the AF and CAD groups, respectively. The observation time with RAO-free was shorter for AF compared with CAD group (1490 versus 1819 days). AF and CAD were both risk factors for RAO with different hazard ratios. To tackle both AF and CAD is crucial for curbing RAO.
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Yen et al. (2015) conducted a cohort in Retinal Artery Occlusion (n=239,468). Atrial fibrillation and Coronary artery disease vs. Age- and sex-matched patients without atrial fibrillation or coronary artery disease was evaluated on Development of retinal artery occlusion (RAO) (adjusted HR 8.32, 95% CI 3.70-18.32, p=<0.0001). Atrial fibrillation and coronary artery disease were both associated with a significantly increased risk of later developing retinal artery occlusion, with adjusted hazard ratios of 8.32 and 5.34, respectively.
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