ReviewCorneal arcus as coronary artery disease risk factor
Introduction
Estimates of individual atherosclerotic cardiovascular disease (ASCVD) risk are based on historical or physical examination findings of atherosclerosis as well as measurements of atherosclerotic risk factors, such as serum lipids, blood pressure, and cigarette use [1]. Such estimates are not exact and have prompted the use of nontraditional risk factors, such as lipoprotein particle size, high sensitivity C-reactive protein [2], lipoprotein a, and coronary artery calcification scoring [3] to assess ASCVD risk more accurately. Corneal arcus was first suggested as a cardiac risk factor by Virchow in 1852 [4], and has been supported by several subsequent studies. The present report presents a systematic review of corneal arcus as a coronary heart disease (CHD) risk factor.
Section snippets
Methods
We performed a systematic literature search of articles published in English with Pub Med through July 2005 using the search terms “corneal arcus” alone and in combination with “coronary heart disease”, “hypercholesterolemia” or “atherosclerosis”. Abstracts and the retrieved articles relevant to corneal arcus, atherosclerotic disease and hypercholesterolemia were reviewed in detail. Older references from these articles were also reviewed. Studies based on small number of patients were not
Summary
Corneal arcus is a recognized sign of hyperlipidemia. It has been associated with CHD since Virchow's initial observation in 1852, but despite the length of this association, it is still not clear whether corneal arcus’ association with CHD is statistically independent of other risk factors, primarily hyperlipidemia. We suggest that physicians use the presence of corneal arcus to search for hyperlipidemia. In addition, given the association of arcus and CHD, normolipidemic patients with corneal
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