Prediction of cardiovascular events in rheumatoid arthritis using risk age calculations: evaluation of concordance across risk age models.

Autor: Wibetoe G; Preventive Cardio-Rheuma clinic, Department of Rheumatology, Diakonhjemmet Hospital, PO Box 23, Vindern, N-01319, Oslo, Norway. grunde.wibetoe@diakonsyk.no., Sexton J; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway., Ikdahl E; Preventive Cardio-Rheuma clinic, Department of Rheumatology, Diakonhjemmet Hospital, PO Box 23, Vindern, N-01319, Oslo, Norway., Rollefstad S; Preventive Cardio-Rheuma clinic, Department of Rheumatology, Diakonhjemmet Hospital, PO Box 23, Vindern, N-01319, Oslo, Norway., Kitas GD; School of Sport, Exercise and Rehabilitation, University of Birmingham, Birmingham, UK.; Dudley Group NHS Foundation Trust, West Midlands, UK., van Riel P; Radboud Institute for Health Sciences, IQ healthcare, Radboud University Medical Center, Nijmegen, The Netherlands., Gabriel S; Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA., Kvien TK; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway., Douglas K; Dudley Group NHS Foundation Trust, West Midlands, UK., Sandoo A; Dudley Group NHS Foundation Trust, West Midlands, UK.; School of Sport, Health and Exercise Sciences, Bangor University, Bangor, UK., Arts EE; Department of Rheumatic Diseases, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands., Wållberg-Jonsson S; Department of Public Health and Clinical Medicine, Rheumatology, Umeå University, Umeå, Sweden., Dahlqvist SR; Department of Public Health and Clinical Medicine, Rheumatology, Umeå University, Umeå, Sweden., Karpouzas G; Division of Rheumatology, Harbor-UCLA Medical Center, Torrance, CA, USA., Dessein PH; Vrije Universiteit Brussel, Brussels, Belgium.; Universitair Ziekenhuis Brussel, Brussels, Belgium., Tsang L; Rheumatology, Universitair Ziekenhuis Brussel, Brussels, Belgium., El-Gabalawy H; University of Manitoba, Winnipeg, MB, Canada., Hitchon CA; University of Manitoba, Winnipeg, MB, Canada., Pascual-Ramos V; Instituto Nactional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, Mexico., Contreas-Yañes I; Instituto Nactional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, Mexico., Sfikakis PP; First Department of Propedeutic Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece., González-Gay MA; Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, Spain., Colunga-Pedraz IJ; Rheumatology, Hospital Universitario, UANL, Monterrey, Mexico., Galarza-Delgado DA; Hospital Universitario, UANL, Monterrey, Mexico., Azpiri-Lopez JR; Cardiology, Hospital Universitario, UANL, Monterrey, Mexico., Crowson CS; Division of Rheumatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA., Semb AG; Preventive Cardio-Rheuma clinic, Department of Rheumatology, Diakonhjemmet Hospital, PO Box 23, Vindern, N-01319, Oslo, Norway.
Jazyk: angličtina
Zdroj: Arthritis research & therapy [Arthritis Res Ther] 2020 Apr 23; Vol. 22 (1), pp. 90. Date of Electronic Publication: 2020 Apr 23.
DOI: 10.1186/s13075-020-02178-z
Abstrakt: Background: In younger individuals, low absolute risk of cardiovascular disease (CVD) may conceal an increased risk age and relative risk of CVD. Calculation of risk age is proposed as an adjuvant to absolute CVD risk estimation in European guidelines. We aimed to compare the discriminative ability of available risk age models in prediction of CVD in rheumatoid arthritis (RA). Secondly, we also evaluated the performance of risk age models in subgroups based on RA disease characteristics.
Methods: RA patients aged 30-70 years were included from an international consortium named A Trans-Atlantic Cardiovascular Consortium for Rheumatoid Arthritis (ATACC-RA). Prior CVD and diabetes mellitus were exclusion criteria. The discriminatory ability of specific risk age models was evaluated using c-statistics and their standard errors after calculating time until fatal or non-fatal CVD or last follow-up.
Results: A total of 1974 patients were included in the main analyses, and 144 events were observed during follow-up, the median follow-up being 5.0 years. The risk age models gave highly correlated results, demonstrating R 2 values ranging from 0.87 to 0.97. However, risk age estimations differed > 5 years in 15-32% of patients. C-statistics ranged 0.68-0.72 with standard errors of approximately 0.03. Despite certain RA characteristics being associated with low c-indices, standard errors were high. Restricting analysis to European RA patients yielded similar results.
Conclusions: The cardiovascular risk age and vascular age models have comparable performance in predicting CVD in RA patients. The influence of RA disease characteristics on the predictive ability of these prediction models remains inconclusive.
Databáze: MEDLINE
Externí odkaz: