Simple eye examination could predict heart attack risk, says study | Heart attack

A simple non-invasive eye examination may be able to predict risk of heart attack when combined with other information, according to a study.

Researchers found that combining information about the pattern of blood vessels in the retina with traditional clinical factors enabled them to better identify participants’ risk of an attack, compared with established models that only included demographic data.

In an abstract, to be presented at the European Society of Human Genetics annual conference in Vienna on Monday, they detail how they used data from UK Biobank, which contains 500,000 people’s medical and lifestyle records, to calculate a measure named fractal dimension.

They then combined it in a model with factors such as age, sex, systolic blood pressure, body mass index and smoking status, studying people on the database who had experienced a heart attack – also known as myocardial infarction or MI – after their retinal images had been collected.

Ana Villaplana-Velasco, a PhD student at the Usher and Roslin institutes at the University of Edinburgh and the presenting author, said: “Strikingly, we discovered that our model was able to better classify participants with low or high MI risk in UK Biobank when compared with established models that only include demographic data. The improvement of our model was even higher if we added a score related to the genetic propensity of developing MI.”

The researchers said their analysis found that there was a shared genetic basis between fractal dimension and myocardial infarction.

The average age for a heart attack is 60 and they found that their model achieved its best predictive performance more than five years before the heart attack occurred. They hope that, in the future, a simple retinal examination may be able to provide enough information to identify people at risk.

“The calculation of an individualised MI risk from those over 50 years old would seem to be appropriate,” said Villaplana-Velasco. “This would enable doctors to suggest behaviours that could reduce risk, such as giving up smoking and maintaining normal cholesterol and blood pressure.”

The researchers believe it is possible that every condition may have a unique retinal variation profile and suggest their findings may be useful in identifying propensity to other diseases. Villaplana-Velasco said they would like to repeat the analysis separately in males and females to investigate if a sex-specific model for heart attack yields a better risk classification.

Prof Sir Nilesh Samani, medical director at the British Heart Foundation, said: “More research is needed to show that this improvement in prediction is robust. Work will also be required to understand the feasibility of this approach and determine how best to incorporate these scans into routine clinical practice.”

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Dr James Ware, cardiologist, reader in genomic medicine at Imperial College London, and Medical Research Council investigator, cautioned that the research had not been peer-reviewed and that the abstract contained limited detail, but added: “It is well recognised that the retina provides a unique opportunity to directly visualise vessels and assess vascular health. Approaches like this that use computer vision and/or machine learning to detect subtle vascular features predictive of future heart health appear promising.”

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