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Algorithm predicts cardiovascular risk in patients with vein occlusions
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SUFFOLK, England — An algorithm can help clinicians determine the cardiovascular disease risks for patients with retinal vein occlusions, according to results from a decade-long study. This information can be used to guide treatment decisions such as whether lipid-lowering drugs should be prescribed, researchers said.
Steven C. Martin, MD, and colleagues here used an algorithm from the Framingham heart disease study to calculate the coronary heart disease risks and calculated cardiovascular disease risks for 89 patients with retinal vein occlusions (RVOs). Dr. Martin then compared those risks with both the standardized risk and the published incidence of coronary heart disease in England.
Compared with the standardized risk, the 10-year cardiovascular disease risks for patients with RVO was significantly higher than for people without RVO (P = .009). People with RVO had a 21% risk of developing cardiovascular disease compared with 16% of people without RVO.
The 10-year risk, compared to the actual incidence of coronary heart disease in England in people between the ages of 30 and 74, was more than 15% in twice as many males with RVO as expected.
There was a fourfold increase in the proportion of female patients with RVO who had calculated coronary heart disease risks above 15% (P < .0001).
Significant difference was also found in the calculated coronary heart disease risks between patients with central RVO and branch RVO. Patients with branch RVO tended to have higher disease risks because of systolic hypertension (P = .003) and age (P = .017).
"This study shows that it is practicable to calculate the 10-year absolute risk of developing coronary heart disease using the Framingham algorithm in medical ophthalmology practice with a personal computer, and that the calculated risk can be used to inform treatment decisions for the primary prevention of cardiovascular disease in a group of patients at high cardiovascular risk," Dr. Martin wrote in the July issue of British Journal of Ophthalmology.