title: Risk and Risk Periods for Stroke and Acute Myocardial Infarction in Patients with Central Retinal Artery Occlusion.
abstract: OBJECTIVE
  To investigate the risk of stroke and acute myocardial infarction (AMI) in patients with incident central retinal artery occlusion (CRAO).
  
  
  METHODS
  A self-controlled case series (SCCS) study.
  
  
  METHODS
  Patients with incident CRAO from the entire Korean population of 48 million individuals.
  
  
  METHODS
  We used the Korean national claim database (2007-2011) for analyses. After identifying patients with incident CRAO, the relative incidence rate ratios (IRRs) for stroke and AMI in risk periods were measured in these patients using a SCCS method.
  
  
  METHODS
  The IRRs of stroke and AMI by risk periods.
  
  
  RESULTS
  Of 1655 patients with incident CRAO in 2009-2010, 165 had stroke/AMI (ischemic stroke in 139, hemorrhagic stroke in 13, and AMI in 15) in the observation period spanning 365 days before and after the occurrence of CRAO. The IRR of stroke/AMI 1 to 30 days after CRAO occurrence significantly increased (14.0; 95% confidence interval [CI], 8.90-22.00); the IRR peaked during the 1 to 7 days after CRAO occurrence (44.51; 95% CI, 27.07-73.20), and the increased risk was present for the first 30 days. The IRR of stroke/AMI also significantly increased 1 to 30 days (6.82; 95% CI, 4.01-11.60) and 31 to 90 days (2.86; 95% CI, 1.66-4.93) before CRAO occurrence. Subanalysis for only ischemic stroke showed similar, magnified IRRs in the risk periods compared with all events. The IRRs were not significantly different between sexes or age groups (<65 vs. ≥65 years).
  
  
  CONCLUSIONS
  Patients with incident CRAO are at increased risk of ischemic stroke just after CRAO occurrence, and the risk is particularly increased during the first week immediately after the CRAO occurrence. The results suggest that patients with incident CRAO require immediate neurologic evaluation and preventive treatment to reduce mortality and morbidity.
authors: Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors: Sang Jun
authors: SJ
authors: Park
authors: Medical Research Collaborating Center, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Republic of Korea; Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.
authors: Nam-Kyong
authors: NK
authors: Choi
authors: Medical Research Collaborating Center, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Republic of Korea.
authors: Bo Ram
authors: BR
authors: Yang
authors: Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors: Kyu Hyung
authors: KH
authors: Park
authors: Medical Research Collaborating Center, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Republic of Korea.
authors: Joongyub
authors: J
authors: Lee
authors: Office of Pharmacoepidemiology, Korea Institute of Drug Safety and Risk Management, Seoul, Republic of Korea.
authors: Sun-Young
authors: SY
authors: Jung
authors: Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. Electronic address: sejoon1@snu.ac.kr.
authors: Se Joon
authors: SJ
authors: Woo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology*; D009313:National Health Programs / Q000706:statistics & numerical data; D056910:Republic of Korea / Q000453:epidemiology; D015356:Retinal Artery Occlusion / Q000453:epidemiology*; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology*