Rheumatoid arthritis-specific cardiovascular risk scores are not superior to general risk scores: a validation analysis of patients from seven countries.

ObjectivesCardiovascular disease (CVD) risk calculators developed for the general population do not accurately predict CVD events in patients with RA. We sought to externally validate risk calculators recommended for use in patients with RA including the EULAR 1.5 multiplier, the Expanded Cardiovascular Risk Prediction Score for RA (ERS-RA) and QRISK2.MethodsSeven RA cohorts from UK, Norway, Netherlands, USA, South Africa, Canada and Mexico were combined. Data on baseline CVD risk factors, RA characteristics and CVD outcomes (including myocardial infarction, ischaemic stroke and cardiovascular... Mehr ...

Verfasser: Crowson, Cynthia S
Gabriel, Sherine E
Semb, Anne Grete
van Riel, Piet LCM
Karpouzas, George
Dessein, Patrick H
Hitchon, Carol
Pascual-Ramos, Virginia
Kitas, George D
Douglas, Karen
Sandoo, Aamer
Rollefstad, Silvia
Ikdahl, Eirik
Kvien, Tore K
Arts, Elke
Fransen, Jaap
Tsang, Linda
El-Gabalawy, Hani
Yáñez, Irazú Contreras
Matteson, Eric L
Rantapää-Dahlqvist, Solbritt
Wållberg-Jonsson, Solveig
Innala, Lena
Sfikakis, Petros P
Zampeli, Evi
Gonzalez-Gay, Miguel A
Corrales, Alfonso
van de Laar, Mart
Vonkeman, Harald
Meek, Inger
Husni, Elaine
Overman, Robert
Colunga, Iris
Galarza, Dionicio
Dokumenttyp: Artikel
Erscheinungsdatum: 2017
Reihe/Periodikum: Rheumatology, vol 56, iss 7
Verlag/Hrsg.: eScholarship
University of California
Schlagwörter: Biomedical and Clinical Sciences / Clinical Sciences / Immunology / Cardiovascular / Heart Disease / Prevention / Arthritis / Clinical Research / Adult / Age Distribution / Aged / Algorithms / Rheumatoid / Canada / Cardiovascular Diseases / Cohort Studies / Comorbidity / Female / Humans / Incidence / Internationality / Male / Mexico / Middle Aged / Netherlands / Norway / Predictive Value of Tests / Prognosis / Risk Assessment / Severity of Illness Index / Sex Distribution / South Africa / United Kingdom / United States / rheumatoid arthritis / cardiovascular disease / risk prediction / Trans-Atlantic Cardiovascular Consortium for Rheumatoid Arthritis / Public Health and Health Services / Arthritis & Rheumatology
Sprache: unknown
Permalink: https://search.fid-benelux.de/Record/base-27570878
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://escholarship.org/uc/item/0vn1j1fr

ObjectivesCardiovascular disease (CVD) risk calculators developed for the general population do not accurately predict CVD events in patients with RA. We sought to externally validate risk calculators recommended for use in patients with RA including the EULAR 1.5 multiplier, the Expanded Cardiovascular Risk Prediction Score for RA (ERS-RA) and QRISK2.MethodsSeven RA cohorts from UK, Norway, Netherlands, USA, South Africa, Canada and Mexico were combined. Data on baseline CVD risk factors, RA characteristics and CVD outcomes (including myocardial infarction, ischaemic stroke and cardiovascular death) were collected using standardized definitions. Performance of QRISK2, EULAR multiplier and ERS-RA was compared with other risk calculators [American College of Cardiology/American Heart Association (ACC/AHA), Framingham Adult Treatment Panel III Framingham risk score-Adult Treatment Panel (FRS-ATP) and Reynolds Risk Score] using c-statistics and net reclassification index.ResultsAmong 1796 RA patients without prior CVD [mean ( s . d .) age: 54.0 (14.0) years, 74% female], 100 developed CVD events during a mean follow-up of 6.9 years (12430 person-years). Estimated CVD risk by ERS-RA [mean ( s . d .) 8.8% (9.8%)] was comparable to FRS-ATP [mean ( s . d .) 9.1% (8.3%)] and Reynolds [mean ( s . d .) 9.2% (12.2%)], but lower than ACC/AHA [mean ( s . d .) 9.8% (12.1%)]. QRISK2 substantially overestimated risk [mean ( s . d .) 15.5% (13.9%)]. Discrimination was not improved for ERS-RA (c-statistic = 0.69), QRISK2 or EULAR multiplier applied to ACC/AHA compared with ACC/AHA (c-statistic = 0.72 for all) or for FRS-ATP (c-statistic = 0.75). The net reclassification index for ERS-RA was low (-0.8% vs ACC/AHA and 2.3% vs FRS-ATP).ConclusionThe QRISK2, EULAR multiplier and ERS-RA algorithms did not predict CVD risk more accurately in patients with RA than CVD risk calculators developed for the general population.