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Acute Vascular Ischemic Events in Patients With Central Retinal Artery Occlusion in the United States: A Nationwide Study 2003-2014
Journal article   Peer reviewed

Acute Vascular Ischemic Events in Patients With Central Retinal Artery Occlusion in the United States: A Nationwide Study 2003-2014

Tahreem A Mir, Ahmad Z Arham, Wei Fang, Fahad Alqahtani, Mohamad Alkhouli, Julia Gallo and David M Hinkle
American journal of ophthalmology, Vol.200, pp.179-186
04/01/2019
DOI: 10.1016/j.ajo.2019.01.009
PMCID: PMC6542256
PMID: 30689989
url
https://www.ncbi.nlm.nih.gov/pmc/articles/6542256View
Open Access

Abstract

Central retinal artery occlusion (CRAO) confers a high risk of acute vascular ischemic events, including stroke and myocardial infarction (MI). Understanding the burden and risk factor profile of these ischemic events can serve as a valuable guide for ophthalmologists in the management and appropriate referral of these patients. Retrospective cross-sectional study. The Nationwide Inpatient Sample (NIS) was queried to identify all inpatient admissions with a diagnosis of CRAO in the United States between the years 2003 and 2014. The primary outcome measure was the incidence of in-hospital acute vascular ischemic events. There were an estimated 17 117 CRAO inpatient admissions. The mean age was 68.4 ± 0.1 years and 53% of patients were female. The incidence of in-hospital stroke and acute MI were 12.9% and 3.7%. The incidence of stroke showed an increasing trend over the years, almost doubling in 2014 in comparison to 2003 (15.3% vs 7.7%). The combined risk of in-hospital stroke, transient ischemic attack, acute MI, or mortality was 19%. Female sex, hypertension, carotid artery stenosis, aortic valve disease, smoking, and alcohol dependence or abuse were positive predictors of in-hospital stroke. There is a significant burden of vascular risk factors, associated with an increased risk of in-hospital stroke, acute MI, and death in CRAO patients. The risk of CRAO-associated stroke is highest in women and in those with a history of hypertension, carotid artery stenosis, aortic valve disease, smoking, or alcohol abuse.
 Acute Disease Aged Aged, 80 and over Brain Ischemia - diagnosis Brain Ischemia - epidemiology Cross-Sectional Studies Female Hospitals - statistics & numerical data Humans Incidence Male Middle Aged Myocardial Infarction - diagnosis Myocardial Infarction - epidemiology Retinal Artery Occlusion - diagnosis Retinal Artery Occlusion - epidemiology Retrospective Studies Risk Factors Stroke - diagnosis Stroke - epidemiology United States - epidemiology Visual Acuity

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