{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T02:47:12Z","timestamp":1788922032473,"version":"build-2803163510"},"reference-count":44,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,9,18]],"date-time":"2023-09-18T00:00:00Z","timestamp":1694995200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: We aimed to analyse data on retinal artery occlusion (RAO) patients to explore correlations with acute ischaemic stroke (AIS), ST-elevation myocardial infarction (STEMI), and cardio\/cerebrovascular comorbidities. Patients and Methods: Our retrospective cohort study included 169 RAO and 169 age- and gender-matched control patients. We examined the association of AIS, STEMI, and related comorbidities such as hypertension (HT), type 1 and type 2 diabetes (T1DM and T2DM, respectively), hyperlipidaemia, and ischaemic heart disease (IHD) with RAO. We also recorded atrial fibrillation in our RAO patients. Results: Our results demonstrated that RAO patients developed both AIS and STEMI at a significantly higher rate compared to controls (p &lt; 0.001 for both). We also found that RAO patients had a significantly higher prevalence of HT and hyperlipidaemia (p1 = 0.005, p2 &lt; 0.001) compared to controls. Multiple risk factors together significantly increased the odds of developing AIS and STEMI. Conclusions: Our results suggest that through identifying and treating the risk factors for RAO patients, we can reduce the risk of AIS, STEMI, and RAO of the fellow eye. Considering that ophthalmologists are often the first detectors of these cardiovascularly burdened patients, collaboration with colleagues from internal medicine, cardiology, and neurology is essential to achieve secondary prevention.<\/jats:p>","DOI":"10.3390\/medicina59091680","type":"journal-article","created":{"date-parts":[[2023,9,18]],"date-time":"2023-09-18T02:17:30Z","timestamp":1695003450000},"page":"1680","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Analysis of the Association between Retinal Artery Occlusion and Acute Ischaemic Stroke\/ST-Elevation Myocardial Infarction and Risk Factors in Hungarian Patients"],"prefix":"10.3390","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5554-7415","authenticated-orcid":false,"given":"Szabolcs","family":"Balla","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Attila","family":"Vajas","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orsolya","family":"P\u00e1sztor","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anik\u00f3","family":"Rentka","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bal\u00e1zs","family":"Lukucz","sequence":"additional","affiliation":[{"name":"Department of Technology and Economics, University of Budapest, 1111 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00e1rta","family":"Kasza","sequence":"additional","affiliation":[{"name":"Medical Centre, Hungarian Defence Forces, 1134 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Attila","family":"Nagy","sequence":"additional","affiliation":[{"name":"Department of Health Informatics, Faculty of Health Sciences, University of Debrecen, 4028 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariann","family":"Fodor","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Val\u00e9ria","family":"Nagy","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,18]]},"reference":[{"key":"ref_1","unstructured":"Hannah Ritchie, L.R.-G., Mathieu, E., Gerber, M., Ortiz-Ospina, E., Hasell, J., and Roser, M. (2023, September 03). Population Growth. Available online: https:\/\/ourworldindata.org."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s11883-018-0711-4","article-title":"Cardiorespiratory Fitness and Cardiovascular Disease Prevention: An Update","volume":"20","author":"Sakr","year":"2018","journal-title":"Curr. Atheroscler. Rep."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"NCD Countdown 2030 Collaborators (2020). NCD Countdown 2030: Pathways to achieving Sustainable Development Goal target 3.4. Lancet, 396, 918\u2013934.","DOI":"10.1016\/S0140-6736(20)31761-X"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1016\/j.preteyeres.2011.05.001","article-title":"Acute retinal arterial occlusive disorders","volume":"30","author":"Hayreh","year":"2011","journal-title":"Prog. Retin. Eye Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.preteyeres.2014.04.001","article-title":"Ocular vascular occlusive disorders: Natural history of visual outcome","volume":"41","author":"Hayreh","year":"2014","journal-title":"Prog. Retin. Eye Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"105828","DOI":"10.1016\/j.jstrokecerebrovasdis.2021.105828","article-title":"Structural and Functional Imaging of the Retina in Central Retinal Artery Occlusion\u2014Current Approaches and Future Directions","volume":"30","author":"Schrag","year":"2021","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"950","DOI":"10.1007\/s00417-005-0140-2","article-title":"Multicenter study of the European Assessment Group for Lysis in the Eye (EAGLE) for the treatment of central retinal artery occlusion: Design issues and implications. EAGLE Study report no. 1: EAGLE Study report no. 1","volume":"244","author":"Feltgen","year":"2006","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.1016\/j.ophtha.2010.03.061","article-title":"Central retinal artery occlusion: Local intra-arterial fibrinolysis versus conservative treatment, a multicenter randomized trial","volume":"117","author":"Schumacher","year":"2010","journal-title":"Ophthalmology"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Tobalem, S., Schutz, J.S., and Chronopoulos, A. (2018). Central retinal artery occlusion\u2014Rethinking retinal survival time. BMC Ophthalmol., 18.","DOI":"10.1186\/s12886-018-0768-4"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1016\/j.ophtha.2018.03.054","article-title":"Management of Acute Retinal Ischemia: Follow the Guidelines!","volume":"125","author":"Biousse","year":"2018","journal-title":"Ophthalmology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1684","DOI":"10.4103\/ijo.IJO_1446_18","article-title":"Central retinal artery occlusion","volume":"66","author":"Hayreh","year":"2018","journal-title":"Indian J. Ophthalmol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"227","DOI":"10.4103\/ijo.IJO_1681_20","article-title":"Giant cell arteritis: Its ophthalmic manifestations","volume":"69","author":"Hayreh","year":"2021","journal-title":"Indian J. Ophthalmol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2064","DOI":"10.1161\/STR.0b013e318296aeca","article-title":"An updated definition of stroke for the 21st century: A statement for healthcare professionals from the American Heart Association\/American Stroke Association","volume":"44","author":"Sacco","year":"2013","journal-title":"Stroke"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1007\/s40123-018-0126-x","article-title":"Ischemic Stroke Risk in Medicare Beneficiaries with Central Retinal Artery Occlusion: A Retrospective Cohort Study","volume":"7","author":"French","year":"2018","journal-title":"Ophthalmol. Ther."},{"key":"ref_15","first-page":"464","article-title":"Cardiac rehabilitation after STEMI","volume":"66","author":"Urbinati","year":"2018","journal-title":"Minerva Cardioangiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.hjc.2019.01.001","article-title":"Challenges and unanswered questions in STEMI management","volume":"60","author":"Koutsoukis","year":"2019","journal-title":"Hell. J. Cardiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1881","DOI":"10.1016\/j.ophtha.2015.05.044","article-title":"Cardiovascular Risk Factors in Central Retinal Artery Occlusion: Results of a Prospective and Standardized Medical Examination","volume":"122","author":"Callizo","year":"2015","journal-title":"Ophthalmology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1927","DOI":"10.1016\/S0140-6736(20)31559-2","article-title":"Retinal vascular occlusions","volume":"396","author":"Scott","year":"2020","journal-title":"Lancet"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2781","DOI":"10.1016\/j.jstrokecerebrovasdis.2018.06.006","article-title":"Is Management of Central Retinal Artery Occlusion the Next Frontier in Cerebrovascular Diseases?","volume":"27","author":"Limaye","year":"2018","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.ajo.2018.08.027","article-title":"Stroke Risk and Risk Factors in Patients With Central Retinal Artery Occlusion","volume":"196","author":"Lavin","year":"2018","journal-title":"Am. J. Ophthalmol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Poznyak, A., Grechko, A.V., Poggio, P., Myasoedova, V.A., Alfieri, V., and Orekhov, A.N. (2020). The Diabetes Mellitus-Atherosclerosis Connection: The Role of Lipid and Glucose Metabolism and Chronic Inflammation. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21051835"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.1016\/j.jstrokecerebrovasdis.2019.03.017","article-title":"Atrial Fibrillation: An Underestimated Cause of Ischemic Monocular Visual Loss?","volume":"28","author":"Zarkali","year":"2019","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e78","DOI":"10.1016\/j.jacc.2012.11.019","article-title":"2013 ACCF\/AHA guideline for the management of ST-elevation myocardial infarction: A report of the American College of Cardiology Foundation\/American Heart Association Task Force on Practice Guidelines","volume":"61","author":"Kushner","year":"2013","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1038\/s41572-019-0106-z","article-title":"Atherosclerosis","volume":"5","author":"Libby","year":"2019","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1038\/eye.2016.111","article-title":"Associations of retinal artery occlusion and retinal vein occlusion to mortality, stroke, and myocardial infarction: A systematic review","volume":"30","author":"Woo","year":"2016","journal-title":"Eye"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1161\/STROKEAHA.115.010828","article-title":"Retinal Artery Occlusion and the Risk of Stroke Development: Twelve-Year Nationwide Cohort Study","volume":"47","author":"Rim","year":"2016","journal-title":"Stroke"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"15245","DOI":"10.1038\/s41598-021-94121-8","article-title":"Cardiovascular risk factors associated with acute myocardial infarction and stroke in the MADIABETES cohort","volume":"11","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1097\/WNO.0000000000000888","article-title":"Retinal Vascular Signs and Cerebrovascular Diseases","volume":"40","author":"Rim","year":"2020","journal-title":"J. Neuroophthalmol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"30","DOI":"10.7570\/jomes.2019.28.1.30","article-title":"Relationship between Obesity and Korean and Mediterranean Dietary Patterns: A Review of the Literature","volume":"28","author":"Choi","year":"2019","journal-title":"J. Obes. Metab. Syndr."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Hong, J.H., Sohn, S.I., Kwak, J., Yoo, J., Ahn, S.J., Woo, S.J., Jung, C., Yum, K.S., Bae, H.J., and Chang, J.Y. (2017). Retinal artery occlusion and associated recurrent vascular risk with underlying etiologies. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0177663"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1337","DOI":"10.1080\/02713683.2019.1641826","article-title":"Prevalence of Atrial Fibrillation in Patients with Retinal Vessel Occlusion and Its Association: A Systematic Review and Meta-Analysis","volume":"44","author":"Kewcharoen","year":"2019","journal-title":"Curr. Eye Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.ajo.2019.01.009","article-title":"Acute Vascular Ischemic Events in Patients With Central Retinal Artery Occlusion in the United States: A Nationwide Study 2003-2014","volume":"200","author":"Mir","year":"2019","journal-title":"Am. J. Ophthalmol."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Chang, Y.S., Ho, C.H., Chu, C.C., Wang, J.J., Tseng, S.H., and Jan, R.L. (2018). Risk of retinal artery occlusion in patients with diabetes mellitus: A retrospective large-scale cohort study. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0201627"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Gaggini, M., Gorini, F., and Vassalle, C. (2022). Lipids in Atherosclerosis: Pathophysiology and the Role of Calculated Lipid Indices in Assessing Cardiovascular Risk in Patients with Hyperlipidemia. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24010075"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2336","DOI":"10.1016\/j.ophtha.2015.07.018","article-title":"Risk and Risk Periods for Stroke and Acute Myocardial Infarction in Patients with Central Retinal Artery Occlusion","volume":"122","author":"Park","year":"2015","journal-title":"Ophthalmology"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1016\/j.ajo.2012.03.046","article-title":"Retinal artery occlusion and the 3-year risk of stroke in Taiwan: A nationwide population-based study","volume":"154","author":"Chang","year":"2012","journal-title":"Am. J. Ophthalmol."},{"key":"ref_37","first-page":"e282","article-title":"Management of Central Retinal Artery Occlusion: A Scientific Statement From the American Heart Association","volume":"52","author":"Schrag","year":"2021","journal-title":"Stroke"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1016\/j.jvs.2019.08.279","article-title":"Retinal artery occlusion does not portend an increased risk of stroke","volume":"72","author":"Laczynski","year":"2020","journal-title":"J. Vasc. Surg."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"105531","DOI":"10.1016\/j.jstrokecerebrovasdis.2020.105531","article-title":"Management of Acute Central Retinal Artery Occlusion, a \u201cRetinal Stroke\u201d: An Institutional Series and Literature Review","volume":"30","author":"Lee","year":"2021","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Roskal-Walek, J., Walek, P., Biskup, M., Sidlo, J., Ciesla, E., Odrobina, D., Mackiewicz, J., and Wozakowska-Kaplon, B. (2022). Retinal Artery Occlusion and Its Impact on the Incidence of Stroke, Myocardial Infarction, and All-Cause Mortality during 12-Year Follow-Up. J. Clin. Med., 11.","DOI":"10.3390\/jcm11144076"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1056\/NEJMoa1800410","article-title":"Clopidogrel and Aspirin in Acute Ischemic Stroke and High-Risk TIA","volume":"379","author":"Johnston","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.ihj.2019.04.001","article-title":"Aspirin for primary prevention: Is this the end of the road?","volume":"71","author":"Singal","year":"2019","journal-title":"Indian Heart J."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1001\/jama.2018.20578","article-title":"Association of Aspirin Use for Primary Prevention With Cardiovascular Events and Bleeding Events: A Systematic Review and Meta-analysis","volume":"321","author":"Zheng","year":"2019","journal-title":"JAMA"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1167\/tvst.10.11.2","article-title":"Risk of Stroke, Myocardial Infarction, and Death Among Patients With Retinal Artery Occlusion and the Effect of Antithrombotic Treatment","volume":"10","author":"Vestergaard","year":"2021","journal-title":"Transl. Vis. Sci. Technol."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/9\/1680\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:52:43Z","timestamp":1760129563000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/9\/1680"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,18]]},"references-count":44,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2023,9]]}},"alternative-id":["medicina59091680"],"URL":"https:\/\/doi.org\/10.3390\/medicina59091680","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,18]]}}}