Evidence map›Paper›PMID 31812251›Full record

ArticleAtherosclerosis2020

Retinal microvascular findings and risk of incident peripheral artery disease: An analysis from the Atherosclerosis Risk in Communities (ARIC) Study.

Chao Yang, Lucia Kwak, Shoshana H Ballew, Bernard G Jaar, Jennifer A Deal, Aaron R Folsom, Gerardo Heiss, A Richey Sharrett, Elizabeth Selvin, Charumathi Sabanayagam and 2 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Atherosclerosis, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 3 pooled it
3.8field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 3 syntheses or guidelines pooled it, 35 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Guideline
  4. Article
  5. Establishing an objective quantitative method for assessing the severity of plus disease in retinopathy of prematurity.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2025
    Article
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  8. Epidemiology and Burden of Peripheral Artery Disease in People With Type 2 Diabetes: A Systematic Literature Review.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2024
    Review
  9. Clinical Potential of Hydrogen Sulfide in Peripheral Arterial Disease.International journal of molecular sciences · 2023
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors at 4 institutions in 2 countries.

Chao YangJohns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Lucia KwakJohns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Shoshana H BallewJohns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Bernard G JaarJohns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Johns Hopkins University School of Medicine, Baltimore, MD, USA; Nephrology Center of Maryland, Baltimore, MD, USA.
Jennifer A DealJohns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Aaron R FolsomUniversity of Minnesota School of Public Health, Minneapolis, MN, USA.
Gerardo HeissUniversity of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA.
A Richey SharrettJohns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Elizabeth SelvinJohns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Charumathi SabanayagamSingapore Eye Research Institute, Singapore National Eye Centre, Singapore.
Josef CoreshJohns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Kunihiro MatsushitaJohns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: kuni.matsushita@jhu.edu.
Johns Hopkins University · USSingapore National Eye Center · SGUniversity of Minnesota · USUniversity of North Carolina at Chapel Hill · US

Funding

Role and Mechanism of Hearing Impairment in Cognitive Decline and DementiaK01AG054693 · NIA · JOHNS HOPKINS UNIVERSITY · PI DEAL, JENNIFER ANNE · 2017 to 2022
$773k
National Trend and Predictors of Critical Limb Ischemia HospitalizationsR21HL133694 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI MATSUSHITA, KUNIHIRO · 2016 to 2017
$245k
NHLBI NIH HHS HHSN268201100005CNHLBI NIH HHS HHSN268201100005GNHLBI NIH HHS HHSN268201100005INHLBI NIH HHS HHSN268201100006CNHLBI NIH HHS HHSN268201100007CNHLBI NIH HHS HHSN268201100007INHLBI NIH HHS HHSN268201100008CNHLBI NIH HHS HHSN268201100008INHLBI NIH HHS HHSN268201100009CNHLBI NIH HHS HHSN268201100009INHLBI NIH HHS HHSN268201100010CNHLBI NIH HHS HHSN268201100011CNHLBI NIH HHS HHSN268201100011INHLBI NIH HHS HHSN268201100012CNHLBI NIH HHS R21 HL133694NIA NIH HHS K01 AG054693
6 · The paper itself

Abstract

BACKGROUND AND

aimsLower-extremity peripheral artery disease (PAD) is usually considered large artery disease. Interestingly, retinal microvascular findings were shown to predict PAD progression in diabetes. However, it is unknown whether retinal microvascular parameters are associated with incident PAD and its severe form, critical limb ischemia (CLI), in a community-based cohort.

methodsAmong 9371 ARIC participants (aged 49-72 years) free of a history of PAD, we quantified the associations of several retinal measures by retinal photography during the period 1993-1995 with PAD risk using Cox models. Incident PAD was defined as the first hospitalization with PAD diagnosis or leg revascularization (considered CLI if an additional diagnosis of ulcer, gangrene, or amputation).

resultsDuring a median follow-up of 18.8 years, 303 participants developed PAD (including 91 CLI cases). Although generalized retinal arteriolar narrowing was not associated with PAD, most measures of retinopathy demonstrated strong associations with PAD beyond potential confounders including diabetes, with adjusted hazard ratios (HR) of 3.26 (95% CI 2.18-4.90) for blot-shaped hemorrhages, 3.11 (1.83-5.29) for hard exudates, and 2.18 (1.62-2.95) for any retinopathy. Adjusted HRs were significantly greater for CLI (ranging from 3.2 to 5.9) than for PAD (all p-values <0.05). Retinopathy measures showed particularly strong associations in participants with diabetes (p-value for interaction [vs. those without diabetes] <0.001).

conclusionsSeveral retinopathy measures were strongly associated with PAD, especially with CLI and in diabetes. Our results support the contribution of microvascular abnormalities to the development and progression of PAD and would have implications on its preventive and therapeutic approaches.

Indexed as

AgedArteriolesCohort StudiesFemaleHumansIncidenceMaleMiddle AgedPeripheral Arterial DiseasePredictive Value of TestsRetinal ArteryRisk AssessmentCritical limb ischemiaMicrovascular diseasePeripheral artery diseaseRetinopathy

Identifiers

PMID31812251
PMCPMC7012766
OpenAlexW2980001163

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.