Time and again on general examination we have come across lipid plaques on the eye lids of our patients. Here is a study highlighting its significance.

Team@CMHF

The presence of the lipid-containing yellow plaques known as xanthelasmata on the eyelids is an independent predictor of cardiovascular disease, a large prospective study found.

At baseline, xanthelasmata were present in 4.4% and arcus corneae in 24.8%.

Individuals with either condition had higher total cholesterol, LDL cholesterol, triglycerides, and apolipoprotein B.

Those with the eyelid lesions had lower levels of apolipoprotein A1 and HDL cholesterol, and those who had arcus corneae had higher levels of lipoprotein(a).

For participants who had both xanthelasmata and arcus corneae, the risk was elevated for myocardial infarction and ischemic heart disease.

Severe atherosclerosis, as determined by an ankle-brachial index below 0.9, was more common in participants with either of the ocular conditions, but after adjustment the risk remained only for xanthelasmata (OR 1.69, 95% CI 1.03 to 2.79).

The researchers also calculated absolute 10-year risks for cardiovascular events, and found that the risk for myocardial infarction in men ages 70 to 79 with xanthelasmata was 28% compared with 19% for those without the ocular plaques.

For ischemic heart disease, men of that age with and without xanthelasmata had risks of 53% and 41%.

They noted that a 10-year risk of 20% is considered sufficiently high to warrant lipid-lowering treatment.

Absolute 10-year risks were lower in women with and without xanthelasmata, being 14% and 9% for myocardial infarction and 35% and 27% for ischemic heart disease.

“Our results clearly establish for the first time that people with xanthelasmata have an increased risk of cardiovascular disease regardless of plasma cholesterol and triglyceride concentrations,” the researchers wrote.

Overall, the evidence highlights the importance of a comprehensive physical examination and suggests that xanthelasmata could be used by general clinicians to help identify people at higher risk of cardiovascular disease,” wrote Antonio B. Fernandez, MD.

Individuals with xanthelasmata “may have an enhanced biological propensity to deposition of cholesterol in vascular and soft tissue, which is not fully represented by their fasting lipid profiles,” Fernandez and Thompson observed

Ref: http://www.medpagetoday.com/Cardiology/Atherosclerosis/28541?utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC&eun=g333280d0r&userid=333280&email=drchasrani@cmhs.in