A novel algorithm for cardiovascular screening using conjunctival microcirculatory parameters and blood biomarkers

Agnes Awuah, Julie Moore, M. Andrew Nesbit, Mark Ruddock, Paul Brennan, Mailey Jonathan, Andrew McNeil, Min Jing, Dewar Finlay, Emanuele Trucco, Mary Jo Kurth, Joanne Watt, John V. Lamont, Peter Fitzgerald, Mark Spence, James McLaughlin, Tara C. B. Moore

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Microvascular haemodynamic alterations are associated with coronary artery disease (CAD). The conjunctival microcirculation can easily be assessed non-invasively. However, the microcirculation of the conjunctiva has not been previously explored in clinical algorithms aimed at identifying patients with CAD. This case–control study involved 66 patients with post-myocardial infarction and 66 gender-matched healthy controls. Haemodynamic properties of the conjunctival microcirculation were assessed with a validated iPhone and slit lamp-based imaging tool. Haemodynamic properties were extracted with semi-automated software and compared between groups. Biomarkers implicated in the development of CAD were assessed in combination with conjunctival microcirculatory parameters. The conjunctival blood vessel parameters and biomarkers were used to derive an algorithm to aid in the screening of patients for CAD. Conjunctival blood velocity measured in combination with the blood biomarkers (N-terminal pro-brain natriuretic peptide and adiponectin) had an area under receiver operator characteristic curve (AUROC) of 0.967, sensitivity 93.0%, specificity 91.5% for CAD. This study demonstrated that the novel algorithm which included a combination of conjunctival blood vessel haemodynamic properties, and blood-based biomarkers could be used as a potential screening tool for CAD and should be validated for potential utility in asymptomatic individuals.
Original languageEnglish
Article number6545
JournalScientific Reports
Issue number1
Early online date21 Apr 2022
Publication statusPublished online - 21 Apr 2022

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  • Conjunctiva
  • Atherosclerosis
  • Biomarkers
  • Microcirculation
  • Cardiovascular disease


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