Abstract
Purpose :
Vascular risk factors may contribute to glaucomatous optic neuropathy and elucidation of the association between vascular disease and glaucoma can potentially provide new avenues for treatment. We performed a retrospective, observational clinical study to test the hypothesis that comorbid conditions would be independently associated with increased risk of myocardial infarction (MI) in patients with open-angle glaucoma (OAG).
Methods :
We analyzed 14 years of longitudinal data from the National Inpatient Sample database (2001-2014). Cases of OAG were extracted and separated into cohorts with a primary hospital admitting diagnosis of MI and no-MI. Comorbidities in these cases were assessed for association using univariate logistic regression. The Bonferroni method was applied to correct for multiple testing. Comorbidities which remained significant were included in a multivariate logistic regression to determine which risk factors were independently associated with risk of MI.
Results :
There were 1,044,372 OAG cases that were separated into MI (n=23,762, 53.3% female) and no-MI (n=1,020,610, 61.1% female) cohorts. Factors which were independently associated with an increased risk of MI in OAG cases were congestive heart failure (OR=1.711, CI=1.689-1.734, p=<0.001), coronary artery disease (OR:6.02, CI=5.937-6.104, p=<0.001), dyslipidemia (OR:1.382, CI=1.365-1.399, p=<0.001), and sickle cell trait (OR:3.332, CI=1.737-6.39, p=<0.001). Although Atrial fibrillation, Diabetes (uncomplicated), Diabetes (complicated), hypertension, and aortic dissection/aneurysm were associated with statistically significant increased risk of MI in OAG on univariate analysis, these associations were not maintained on multivariate analysis.
Conclusions :
Comorbidities independently associated with an increased risk of MI in OAG patients included congestive heart failure, coronary artery disease, dyslipidemia, and sickle cell trait. These findings may help identify modifiable risk factors which may be suggestive of interventions that can reduce the risk of MI in glaucoma patients. This study also suggests OAG may be a harbinger of early vascular damage in patients with Sickle cell trait, which suggests early ophthalmologic screening may be crucial in this patient population. Further research that aims to elucidate the association between vascular disease and glaucoma can potentially provide new avenues for treatment.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.