Researchers report high rate of atrial fibrillation after central retinal artery occlusion
USA: Patients with central retinal artery occlusion (CRAO) have a higher rate of atrial fibrillation (AF) as detected by using long-term cardiac monitoring, researchers report in Stroke -- the official publication of the American Heart Association. The higher rate of AF in CRAO patients was comparable to stroke patients.
Central retinal artery occlusion is a form of acute ischemic stroke that can cause sudden, irreversible blindness. Brian Mac Grory, Duke University School of Medicine, Durham, NC, and colleagues aimed to determine the proportion of patients in whom atrial fibrillation is detected by extended cardiac monitoring after CRAO.
For this purpose, the researchers performed a retrospective, observational cohort study. They used data from the Optum deidentified electronic health record of 30.8 million people cross-referenced with the Medtronic CareLink database of 2.7 million people with cardiac monitoring devices in situ. The patients were enrolled in 3 groups: (1) CRAO, (2) cerebral ischemic stroke, and (3) age-, sex-, and comorbidity-matched controls.
The primary endpoint was the detection of new AF -- defined as ≥2 minutes of AF detected on a cardiac monitoring device.
The team reviewed 884 431 patient records in common between the two databases to identify 100 patients with CRAO, 6559 with ischemic stroke, and 1000 matched controls.
Based on the study, the researchers found that:
- After CRAO, the cumulative incidence of new AF at 2 years was 49.6%.
- Patients with CRAO had a higher rate of AF than controls (hazard ratio, 1.64) and a comparable rate to patients with stroke (hazard ratio, 1.01).
- CRAO was associated with a higher incidence of new stroke compared with matched controls (hazard ratio, 2.85).
"The rate of AF detection after CRAO is higher than that seen in age-, sex-, and comorbidity-matched controls and comparable to that seen after ischemic cerebral stroke," wrote the authors. "Paroxysmal AF should be considered as part of the differential etiology of CRAO, and those patients may benefit from long-term cardiac monitoring."
The study titled, "Detection of Atrial Fibrillation After Central Retinal Artery Occlusion," is published in the AHA journal Stroke.