TY - JOUR
T1 - Prediction of incident stroke events based on retinal vessel caliber
T2 - A systematic review and individual-participant meta-analysis
AU - McGeechan, Kevin
AU - Liew, Gerald
AU - MacAskill, Petra
AU - Irwig, Les
AU - Klein, Ronald
AU - Klein, Barbara E.K.
AU - Wang, Jie Jin
AU - Mitchell, Paul
AU - Vingerling, Johannes R.
AU - De Jong, Paulus T.V.M.
AU - Witteman, Jacqueline C.M.
AU - Breteler, Monique M.B.
AU - Shaw, Jonathan
AU - Zimmet, Paul
AU - Wong, Tien Y.
PY - 2009/12/1
Y1 - 2009/12/1
N2 - The caliber of the retinal vessels has been shown to be associated with stroke events. However, the consistency and magnitude of association, and the changes in predicted risk independent of traditional risk factors, are unclear. To determine the association between retinal vessel caliber and the risk of stroke events, the investigators combined individual data from 20,798 people, who were free of stroke at baseline, in 6 cohort studies identified from a search of the Medline (National Library of Medicine, Bethesda, Maryland) and EMBASE (Elsevier B.V., Amsterdam, the Netherlands) databases. During follow-up of 5-12 years, 945 (4.5%) incident stroke events were recorded. Wider retinal venular caliber predicted stroke (pooled hazard ratio=1.15, 95% confidence interval: 1.05, 1.25 per 20-μm increase in caliber), but the caliber of retinal arterioles was not associated with stroke (pooled hazard ratio=1.00, 95% confidence interval: 0.92, 1.08). There was weak evidence of heterogeneity in the hazard ratio for retinal venular caliber, which may be attributable to differences in follow-up strategies across studies. Inclusion of retinal venular caliber in prediction models containing traditional stroke risk factors reassigned 10.1% of people at intermediate risk into different, mostly lower, risk categories.
AB - The caliber of the retinal vessels has been shown to be associated with stroke events. However, the consistency and magnitude of association, and the changes in predicted risk independent of traditional risk factors, are unclear. To determine the association between retinal vessel caliber and the risk of stroke events, the investigators combined individual data from 20,798 people, who were free of stroke at baseline, in 6 cohort studies identified from a search of the Medline (National Library of Medicine, Bethesda, Maryland) and EMBASE (Elsevier B.V., Amsterdam, the Netherlands) databases. During follow-up of 5-12 years, 945 (4.5%) incident stroke events were recorded. Wider retinal venular caliber predicted stroke (pooled hazard ratio=1.15, 95% confidence interval: 1.05, 1.25 per 20-μm increase in caliber), but the caliber of retinal arterioles was not associated with stroke (pooled hazard ratio=1.00, 95% confidence interval: 0.92, 1.08). There was weak evidence of heterogeneity in the hazard ratio for retinal venular caliber, which may be attributable to differences in follow-up strategies across studies. Inclusion of retinal venular caliber in prediction models containing traditional stroke risk factors reassigned 10.1% of people at intermediate risk into different, mostly lower, risk categories.
KW - Cohort studies
KW - Meta-analysis
KW - Retinal vessels
KW - Risk
KW - Stroke
UR - http://www.scopus.com/inward/record.url?scp=70849089543&partnerID=8YFLogxK
U2 - 10.1093/aje/kwp306
DO - 10.1093/aje/kwp306
M3 - Article
C2 - 19884126
AN - SCOPUS:70849089543
VL - 170
SP - 1323
EP - 1332
JO - American Journal of Epidemiology
JF - American Journal of Epidemiology
SN - 0002-9262
IS - 11
ER -