Retinal artery lesions and long-term outcome in Chinese patients with acute coronary syndrome

OBJECTIVE: To investigate the relationship between staging of retinal artery lesions and the prognosis of acute coronary syndrome (ACS) in a Chinese population. METHODS: A total of 436 Chinese patients with ACS underwent coronary angiography and the eyes fundus examinations. All the patients were divided into three groups: group 1, no retinal artery lesions (n=111); group 2, retinal artery lesions of <Stage 2 (Stage 1—a broadening of the light reflex from the artery can be seen, with minimal or no arteriovenous compression; n=135); and group 3, retinal artery lesions of ≥Stage 2 (Stage 2—the changes similar to those in Stage 1, but more prominent, Stage 3—the arteries have a ‘copper wire' appearance and this is much more arteriovenous compression, and Stage 4—the arteries have a ‘silver wire' appearance and the arteriovenous crossing changes are more severe; n=190). The endpoints were main adverse cardiovascular and cerebrovascular events (MACCE), including all-cause death, myocardial infarction (MI), and stroke after 3–6 years of follow-up. RESULTS: There was no significant differences of the baseline data among the three groups. After 3–6 years of follow-up, we found that patients of group 3 had more MACCE and death than those of the group 1 or group 2. Cox regression analysis found that factors related to the prognosis of ACS was staging of retinal artery lesions (P<0.05) in addition to traditional risk factors such as age, gender, diabetes, hypertension, and hypercholesterolemia. CONCLUSION: Staging of retinal artery lesions plays an important role in the long-term outcome of patients with ACS.