Prediction of Major Adverse Cardiovascular Events From Retinal, Clinical, and Genomic Data in Individuals With Type 2 Diabetes: A Population Cohort Study

Mordi, I and Trucco, E and Syed, M G and MacGillivray, T and Nar, A and Huang, Yu and George, Gittu and Hogg, Stephen and Radha, V and Prathiba, V and Anjana, R M and Mohan, V and Palmer, C N A and Pearson, E R and Lang, C C and Doney, A S.F (2022) Prediction of Major Adverse Cardiovascular Events From Retinal, Clinical, and Genomic Data in Individuals With Type 2 Diabetes: A Population Cohort Study. Diabetes Care, 45 (3). p. 710. ISSN 0149-5992

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Abstract

Objective: Improved identification of individuals with type 2 diabetes at high cardiovascular (CV) risk could help in selection of newer CV risk-reducing therapies. The aim of this study was to determine whether retinal vascular parameters, derived from retinal screening photographs, alone and in combination with a genome-wide polygenic risk score for coronary heart disease (CHD PRS) would have independent prognostic value over traditional CV risk assessment in patients without prior CV disease. Research design and methods: Patients in the Genetics of Diabetes Audit and Research Tayside Scotland (GoDARTS) study were linked to retinal photographs, prescriptions, and outcomes. Retinal photographs were analyzed using VAMPIRE (Vascular Assessment and Measurement Platform for Images of the Retina) software, a semiautomated artificial intelligence platform, to compute arterial and venous fractal dimension, tortuosity, and diameter. CHD PRS was derived from previously published data. Multivariable Cox regression was used to evaluate the association between retinal vascular parameters and major adverse CV events (MACE) at 10 years compared with the pooled cohort equations (PCE) risk score. Results: Among 5,152 individuals included in the study, a MACE occurred in 1,017 individuals. Reduced arterial fractal dimension and diameter and increased venous tortuosity each independently predicted MACE. A risk score combining these parameters significantly predicted MACE after adjustment for age, sex, PCE, and the CHD PRS (hazard ratio 1.11 per SD increase, 95% CI 1.04-1.18, P = 0.002) with similar accuracy to PCE (area under the curve [AUC] 0.663 vs. 0.658, P = 0.33). A model incorporating retinal parameters and PRS improved MACE prediction compared with PCE (AUC 0.686 vs. 0.658, P < 0.001). Conclusions: Retinal parameters alone and in combination with genome-wide CHD PRS have independent and incremental prognostic value compared with traditional CV risk assessment in type 2 diabetes.

Item Type:Article
Official URL/DOI:http://dx.doi.org/10.2337/dc21-1124
Uncontrolled Keywords:Type 2 Diabetes,Cardiovascular
Subjects:Diabetology > Diabetes Mellitus Type 2
Biochemistry,Cell and Molecular Signalling
Divisions:Department of Diabetology
Department of Advanced Research Biochemistry
ID Code:1298
Deposited By:surendar radha
Deposited On:08 Mar 2022 13:48
Last Modified:08 Mar 2022 13:48

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