Associations of xanthelasma palpebrarum and arcus senilis with cardiovascular disease: a trinetx analysis

To determine whether xanthelasma palpebrarum or arcus senilis are independent risk factors for cardiovascular disease. Design: The TriNetX database was queried to assess the relationship between XP, AS, and various markers of cardiovascular disease. Participants: ICD-10 codes were used to select patients who had XP or AS, as well as matched controls. Methods: Primary outcomes were diagnosis of MI, ischemic stroke, CHF, AFib, PAD, CVD, and major adverse cardiovascular events (MACE) at 1, 5, and 10 years. Subgroup analysis was performed on males and females, as well as on black, indigenous, and people of color (BIPOC) and white patients. Results: Both males (RR 1.178, 95% CI 1.008-1.376) and females (RR 1.242, 95% CI 1.045-1.477) with AS have increased risk of CAD at 10 years and females with AS have higher risk of MI at 10 years (RR 1.491, 95% CI 1.061-2.095). Males with XP have increased risk of CAD at 5 (RR 2, 95% CI 1.057-3.785) and 10 years (RR 2, 95% CI 1.132-3.533), though women with XP do not have increased risk of any of the study outcomes. BIPOC with AS do not have increased risk of any of the study outcomes compared with white patients. AS and XP are not associated with ischemic stroke, CHF, PAD, or MACE. Conclusions: Men with XP and all patients with AS may benefit from screening for CAD.