Use of risk chart algorithms for the identification of psoriatic arthritis patients at high risk for cardiovascular disease: findings derived from the project CARMA cohort after a 7.5-year follow-up period.

Autor:	Polo Y La Borda J; Rheumatology, Hospital Universitario Rey Juan Carlos, Madrid, Spain., Castañeda S; Rheumatology Department, Hospital Universitario La Princesa, IIS-Princesa, Madrid, Spain., Heras-Recuero E; Rheumatology, ISS Fundacion Jimenez Diaz, Madrid, Spain., Sánchez-Alonso F; Research Unit of Spanish Society of Rheumatology, Madrid, Spain., Plaza Z; Research Unit, Spanish Society of Rheumatology, Madrid, Spain., García Gómez C; Rheumatology, Consorci Sanitari de Terrassa, Barcelona, Spain., Ferraz-Amaro I; Rheumatology Unit, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain.; Internal Medicine, Universidad de La Laguna (ULL), Tenerife, Spain., Sanchez-Costa JT; Rheumatology, Research Unit, Spanish Society of Rheumatology, Madrid, Spain., Sánchez-González OC; Rheumatology, Hospital Universitario del Sureste, Madrid, Spain., Turrión-Nieves AI; Rheumatology Department, Hospital Complejo Asistencial Universitario de Salamanca, Salamanca, Spain., Perez-Alcalá A; Rheumatology, Hospital Universitario Príncipe Asturias, Alcalá de Henares, Madrid, Spain., Pérez-García C; Rheumatology Department, Consorci Parc de Salut MAR de Barcelona, Barcelona, Spain., González-Juanatey C; Cardiology, Hospital Universitario Lucus Augusti, Lugo, Spain.; Biodiscovery HULA-USC Group, Instituto de Investigación Sanitaria de Santiago de Compostela IDIS, Santiago de Compostela, Spain., Llorca J; Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP) and Department of Medical and Surgical Sciences, University of Cantabria, Santander, Spain.; CARMA Project Collaborative Group, Madrid, Spain., Gonzalez-Gay MA; Rheumatology, ISS Fundacion Jimenez Diaz, Madrid, Spain miguelaggay@hotmail.com.; Department of Medicine and Psychiatry, Medicine, University of Cantabria, Santander, Spain.
Jazyk:	angličtina
Zdroj:	RMD open [RMD Open] 2024 Apr 17; Vol. 10 (2). Date of Electronic Publication: 2024 Apr 17.
DOI:	10.1136/rmdopen-2024-004207
Abstrakt:	Objective: To assess the predictive value of four cardiovascular (CV) risk algorithms for identifying high-risk psoriatic arthritis (PsA) patients. Methods: Evaluation of patients with PsA enrolled in the Spanish prospective project CARdiovascular in RheuMAtology. Baseline data of 669 PsA patients with no history of CV events at the baseline visit, who were followed in rheumatology outpatient clinics at tertiary centres for 7.5 years, were retrospectively analysed to test the performance of the Systematic Coronary Risk Assessment (SCORE), the modified version (mSCORE) European Alliance of Rheumatology Associations (EULAR) 2015/2016, the SCORE2 algorithm (the updated and improved version of SCORE) and the QRESEARCH risk estimator version 3 (QRISK3). Results: Over 4790 years of follow-up, there were 34 CV events, resulting in a linearised rate of 7.10 per 1000 person-years (95% CI 4.92 to 9.92). The four CV risk scales showed strong correlations and all showed significant associations with CV events (p<0.001). SCORE, mSCORE EULAR 2015/2016 and QRISK3 effectively differentiated between low and high CV risk patients, although the cumulative rate of CV events observed over 7.5 years was lower than expected based on the frequency predicted by these risk scales. Additionally, model improvement was observed when combining QRISK3 with any other scale, particularly the combination of QRISK3 and SCORE2, which yielded the lowest Akaike information criterion (411.15) and Bayesian information criterion (420.10), making it the best predictive model. Conclusions: Risk chart algorithms are very useful for discriminating PsA at low and high CV risk. An integrated model featuring QRISK3 and SCORE2 yielded the optimal synergy of QRISK3's discrimination ability and SCORE2's calibration accuracy. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu