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Article: Retinal microvascular signs and risk of stroke: The Multi-Ethnic Study of Atherosclerosis (MESA)

TitleRetinal microvascular signs and risk of stroke: The Multi-Ethnic Study of Atherosclerosis (MESA)
Authors
Issue Date2012
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://stroke.ahajournals.org
Citation
Stroke, 2012, v. 43 n. 12, p. 3245-3251 How to Cite?
AbstractBackground and Purpose: Small-vessel disease contributes to the pathophysiology of stroke, and retinal microvascular signs have been linked to the risk of stroke. We examined the relationship of retinal signs with incident stroke in a multiethnic cohort. Methods: The Multi-Ethnic Study of Atherosclerosis (MESA) is a prospective cohort study that enrolled participants without clinical cardiovascular diseases from 6 US communities between 2000 and 2002. Of the participants, 4849 (71.2%) had fundus photography performed in 2002 to 2004. Retinopathy and retinal vessel caliber were assessed from retinal images. Stroke risk factors including high-sensitivity C-reactive protein, carotid artery intima-media thickness, and coronary artery calcium were measured using standardized protocols. Incident stroke was confirmed from medical record review and death certificates. Results: After 6 years of follow-up, there were 62 incident strokes. Narrower retinal arteriolar caliber was associated with increased risk of stroke after adjusting for conventional cardiovascular risk factors (adjusted incidence rate ratio, 2.83; 95% CI, 1.34 - 5.95; P=0.006; adjusted hazard ratio, 3.01; 95% CI, 1.29-6.99; P=0.011). Retinopathy in persons without diabetes was associated with increased risk of stroke (adjusted adjusted incidence rate ratio, 2.96; 95% CI, 1.50-5.84; P=0.002; adjusted hazard ratio, 3.07; 95% CI, 1.17-8.09; P=0.023). These associations remained significant after adjusting for high-sensitivity C-reactive protein, carotid intima-media thickness, or coronary artery calcium. Conclusions: Narrower retinal arteriolar caliber and retinopathy in nondiabetic persons were associated with increased risk of stroke in this relatively healthy multiethnic cohort independent of traditional risk factors and measures of atherosclerosis. The association between narrower retinal arteriolar caliber and stroke warrants further investigation. © 2012 American Heart Association, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/183414
ISSN
2015 Impact Factor: 5.787
2015 SCImago Journal Rankings: 3.671
PubMed Central ID
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorKawasaki, Ren_US
dc.contributor.authorXie, Jen_US
dc.contributor.authorCheung, Nen_US
dc.contributor.authorLamoureux, Een_US
dc.contributor.authorKlein, Ren_US
dc.contributor.authorKlein, BEKen_US
dc.contributor.authorCotch, MFen_US
dc.contributor.authorSharrett, ARen_US
dc.contributor.authorShea, Sen_US
dc.contributor.authorWong, TYen_US
dc.date.accessioned2013-05-27T07:13:22Z-
dc.date.available2013-05-27T07:13:22Z-
dc.date.issued2012en_US
dc.identifier.citationStroke, 2012, v. 43 n. 12, p. 3245-3251en_US
dc.identifier.issn0039-2499en_US
dc.identifier.urihttp://hdl.handle.net/10722/183414-
dc.description.abstractBackground and Purpose: Small-vessel disease contributes to the pathophysiology of stroke, and retinal microvascular signs have been linked to the risk of stroke. We examined the relationship of retinal signs with incident stroke in a multiethnic cohort. Methods: The Multi-Ethnic Study of Atherosclerosis (MESA) is a prospective cohort study that enrolled participants without clinical cardiovascular diseases from 6 US communities between 2000 and 2002. Of the participants, 4849 (71.2%) had fundus photography performed in 2002 to 2004. Retinopathy and retinal vessel caliber were assessed from retinal images. Stroke risk factors including high-sensitivity C-reactive protein, carotid artery intima-media thickness, and coronary artery calcium were measured using standardized protocols. Incident stroke was confirmed from medical record review and death certificates. Results: After 6 years of follow-up, there were 62 incident strokes. Narrower retinal arteriolar caliber was associated with increased risk of stroke after adjusting for conventional cardiovascular risk factors (adjusted incidence rate ratio, 2.83; 95% CI, 1.34 - 5.95; P=0.006; adjusted hazard ratio, 3.01; 95% CI, 1.29-6.99; P=0.011). Retinopathy in persons without diabetes was associated with increased risk of stroke (adjusted adjusted incidence rate ratio, 2.96; 95% CI, 1.50-5.84; P=0.002; adjusted hazard ratio, 3.07; 95% CI, 1.17-8.09; P=0.023). These associations remained significant after adjusting for high-sensitivity C-reactive protein, carotid intima-media thickness, or coronary artery calcium. Conclusions: Narrower retinal arteriolar caliber and retinopathy in nondiabetic persons were associated with increased risk of stroke in this relatively healthy multiethnic cohort independent of traditional risk factors and measures of atherosclerosis. The association between narrower retinal arteriolar caliber and stroke warrants further investigation. © 2012 American Heart Association, Inc.en_US
dc.languageengen_US
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://stroke.ahajournals.orgen_US
dc.relation.ispartofStrokeen_US
dc.subject.meshAfrican Continental Ancestry Group - Statistics & Numerical Dataen_US
dc.subject.meshAgeden_US
dc.subject.meshArterioles - Pathologyen_US
dc.subject.meshAsian Americans - Statistics & Numerical Dataen_US
dc.subject.meshAtherosclerosis - Ethnology - Pathologyen_US
dc.subject.meshEuropean Continental Ancestry Group - Statistics & Numerical Dataen_US
dc.subject.meshFemaleen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshHispanic Americans - Statistics & Numerical Dataen_US
dc.subject.meshHumansen_US
dc.subject.meshIncidenceen_US
dc.subject.meshKaplan-Meier Estimateen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshRetinal Diseases - Ethnology - Pathologyen_US
dc.subject.meshRetinal Vessels - Pathologyen_US
dc.subject.meshRisk Factorsen_US
dc.subject.meshStroke - Ethnologyen_US
dc.titleRetinal microvascular signs and risk of stroke: The Multi-Ethnic Study of Atherosclerosis (MESA)en_US
dc.typeArticleen_US
dc.identifier.emailCheung, N: dannycheung@hotmail.comen_US
dc.identifier.authorityCheung, N=rp01752en_US
dc.description.naturelink_to_OA_fulltexten_US
dc.identifier.doi10.1161/STROKEAHA.112.673335en_US
dc.identifier.pmid23111439-
dc.identifier.pmcidPMC3508325-
dc.identifier.scopuseid_2-s2.0-84870925461en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-84870925461&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume43en_US
dc.identifier.issue12en_US
dc.identifier.spage3245en_US
dc.identifier.epage3251en_US
dc.identifier.isiWOS:000311497600026-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridKawasaki, R=55444101400en_US
dc.identifier.scopusauthoridXie, J=55314055200en_US
dc.identifier.scopusauthoridCheung, N=55443689200en_US
dc.identifier.scopusauthoridLamoureux, E=7003839871en_US
dc.identifier.scopusauthoridKlein, R=35232138400en_US
dc.identifier.scopusauthoridKlein, BEK=7401551106en_US
dc.identifier.scopusauthoridCotch, MF=6603036992en_US
dc.identifier.scopusauthoridSharrett, AR=7006662570en_US
dc.identifier.scopusauthoridShea, S=55443180000en_US
dc.identifier.scopusauthoridWong, TY=35231271400en_US

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