Younger age and female gender are determinants of underestimated cardiovascular risk in rheumatoid arthritis patients: a prospective cohort study.

Autor: Rohrich DC; Department of Rheumatology, Sint Maartenskliniek, Hengstdal nr. 3, 6574 NA, Ubbergen, The Netherlands., van de Wetering EHM; Department of Rheumatology, Radboud University Nijmegen Medical Centre, Geert Grooteplein 8, 6500 HB, Nijmegen, The Netherlands., Rennings AJ; Department of Internal Medicine, Radboud University Nijmegen Medical Centre, Geert Grooteplein 8, 6500 HB, Nijmegen, The Netherlands., Arts EE; Department of Rheumatology, Radboud University Nijmegen Medical Centre, Geert Grooteplein 8, 6500 HB, Nijmegen, The Netherlands., Meek IL; Department of Rheumatology, Radboud University Nijmegen Medical Centre, Geert Grooteplein 8, 6500 HB, Nijmegen, The Netherlands., den Broeder AA; Department of Rheumatology, Sint Maartenskliniek, Hengstdal nr. 3, 6574 NA, Ubbergen, The Netherlands., Fransen J; Department of Rheumatology, Radboud University Nijmegen Medical Centre, Geert Grooteplein 8, 6500 HB, Nijmegen, The Netherlands., Popa CD; Department of Rheumatology, Sint Maartenskliniek, Hengstdal nr. 3, 6574 NA, Ubbergen, The Netherlands. c.popa@maartenskliniek.nl.; Department of Rheumatology, Radboud University Nijmegen Medical Centre, Geert Grooteplein 8, 6500 HB, Nijmegen, The Netherlands. c.popa@maartenskliniek.nl.
Jazyk: angličtina
Zdroj: Arthritis research & therapy [Arthritis Res Ther] 2021 Jan 04; Vol. 23 (1), pp. 2. Date of Electronic Publication: 2021 Jan 04.
DOI: 10.1186/s13075-020-02384-9
Abstrakt: Background: Rheumatoid arthritis (RA) patients have an increased cardiovascular (CV) risk. Here, we aimed to investigate whether gender and age are contributing to the misclassification of CV risk in RA patients.
Methods: Prospectively collected data on cardiovascular risk factors and incident events from the Nijmegen inception cohort were analyzed, with up to 10 years follow-up. Original as well as the EULAR-modified (M)_SCORE algorithms were used to calculate CV risk. Patients were stratified in deciles according to predicted risk; the Hosmer-Lemeshow test was used to check concordance between observed and predicted risk, in subgroups of gender and age.
Results: There were 863 RA patients included with 128 incident CV events. When using SCORE in the whole group, there was evidence of a discrepancy between the predicted and observed CV risk (H-L test p < 0.003), mainly present in the female subgroup (H-L test p < 0.001). Interestingly, 36% of females who developed an event belonged to the low CV risk group, whereas this was just 10% in RA males. When analyzing the subgroups based on age, a discrepancy was present only in the youngest patients (H-L test p < 0.001 in patients < 55 years) consisting of an underestimation of CV risk (5.3% predicted vs. 8.0% observed). Similar results were obtained when the M_SCORE was applied.
Conclusion: CV risk is especially underestimated in female and younger RA patients. This suggests that modifying the weight for the female gender and/or younger age in currently used CV risk algorithms might improve their predictive value in RA, contributing to better CV risk management.
Databáze: MEDLINE
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