Abstract Number: Esoc2026a122 Risk of Major Adverse Cardiovascular Events Following Retinal Vascular Occlusions Versus Transient Ischemic Attack

Abstract Background and aims Retinal vascular occlusion (RVaO) and transient ischemic attack (TIA) are both acute vascular events, yet their comparative cardiovascular risks remain unclear. We aimed to compare the one-year cardiovascular risk between RVaO and TIA patients and to identify independent risk factors for cardiovascular events in RVaO patients. Methods Using the TriNetX database, we identified adult patients diagnosed with RVaO or TIA. Propensity score matching was performed to adjust for baseline characteristics. The primary outcome was major adverse cardiovascular events (MACE), comprising ischemic stroke, hemorrhagic stroke, acute myocardial infarction, and all-cause mortality. Secondary outcomes included individual MACE components. Subgroup analyses were stratified by age, sex, and RVaO subtype. Multivariable Cox regression identified independent risk factors for cardiovascular outcomes. Results After matching, 90,698 patients were included in each cohort. RVaO patients had a significantly lower one-year MACE risk compared to TIA patients (HR 0.77; 95% CI 0.74–0.80), with reduced risks of ischemic stroke (HR 0.64), hemorrhagic stroke (HR 0.82), and AMI (HR 0.89). All-cause mortality was similar between groups. However, central retinal artery occlusion (CRAO) patients showed higher MACE (HR 1.13) and mortality (HR 1.23) risks versus TIA. Independent risk factors for MACE in RVaO included ischemic heart disease (HR 1.59), chronic kidney disease (HR 1.58), and heart failure (HR 1.55). Conclusions RVaO patients generally have lower one-year cardiovascular risk than TIA patients, though CRAO carries similar risk to TIA. These findings highlight the need for subtype-specific risk stratification and urgent cardiovascular assessment in CRAO patients, underscoring the importance of multidisciplinary care in RVaO management. Conflict of interest Sheng-Feng Sung: nothing to disclose. Cheng-Yang Hsieh: nothing to disclose. Chen-Wen Fang: nothing to disclose.