Abstract
Purpose :
To assess the difference in Atherosclerotic Cardiovascular Disease (ASCVD) risk score calculations in patients with confirmed stroke equivalent and stroke-mimic pathologies.
Methods :
This is a retrospective single-institution chart review of patients presenting with a diagnosis of a retinal artery occlusion (a stroke-like condition) and known ophthalmic stroke mimics between 2010 and 2020. Patient data was collected and utilized in the ASCVD risk score calculator pooled cohort equation. Patients without data regarding their sex, race, blood pressure, diabetes mellitus status, smoking status, or lipids were excluded. ASCVD risk scores were calculated using information closest to suspicion of a stroke-like event. Patient data were trended to analyze differences in risk score changes by initial diagnosis and intervention type. The stroke mimic group was divided into subgroups to assess differences based on pathologic process. Data were analyzed for association.
Results :
Of an initial 596 patients with a confirmed stroke-like pathology and 170 patients with a confirmed stroke-mimic pathology, exclusion criteria eliminated 203 and 41 patients, respectively. The 393 stroke-like patients had a median age of 71 ± 12.968 years and a mean ASCVD risk score of 0.305 ± 0.183. The remaining 129 stroke-mimic patients (53.5% female) had a median age of 68 ± 18.869 years and a mean ASCVD risk score of 0.288 ± 0.223. Patients in the stroke-mimic group (47.6% female) were younger (P = 0.005) and had a higher mean HDL (P = 0.0094) than patients in the stroke-like group. There was no difference in ASCVD risk score (P = 0.3735), systolic blood pressure (P = 0.5253), total cholesterol (P = 0.1557), diabetes mellitus diagnosis (P = 0.235), tobacco use history (P = 0.211), or use of antihypertensive medication (P = 0.588).
Conclusions :
The ASCVD risk score was not statistically significant between patients suspected of having a stroke, even when differentiated between stroke-like and stroke-mimic pathologies. This information underscores the need for adjunctive data obtained from these ophthalmic patients to refine the ASCVD risk factor calculation. Although the ASCVD risk score calculator is unable to distinguish between ophthalmic stroke-like and stroke mimic pathologies via the risk score, it is possible that the use of retinal imaging can refine its assessment and correlate with improvement in risk from interventions.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.