Discordance of the Framingham cardiovascular risk score and the 2013 American College of Cardiology/American Heart Association risk score in systemic lupus erythematosus and rheumatoid arthritis

Autor: Jinoos Yazdany, Patricia P. Katz, Gabriela Schmajuk, Zara Izadi, Kashif Jafri, Milena A. Gianfrancesco, Sarah L. Patterson, Atif Qasim, Alexis Ogdie
Rok vydání: 2017
Předmět:
Male
030204 cardiovascular system & hematology
Cardiovascular
Arthritis
Rheumatoid
0302 clinical medicine
Risk Factors
Rheumatoid
Lupus Erythematosus
Systemic
2.1 Biological and endogenous factors
Aetiology
Prospective cohort study
education.field_of_study
Framingham Risk Score
American Heart Association
General Medicine
Middle Aged
Heart Disease
Cardiovascular Diseases
6.1 Pharmaceuticals
Rheumatoid arthritis
Cardiology
Female
Risk assessment
Cohort study
Adult
medicine.medical_specialty
Clinical Sciences
Population
Lupus
Cardiovascular risk score
Rheumatoid Arthritis
Risk Assessment
Autoimmune Disease
Article
03 medical and health sciences
Systemic lupus erythematosus
Rheumatology
Clinical Research
Internal medicine
medicine
Humans
education
Aged
030203 arthritis & rheumatology
Lupus Erythematosus
business.industry
Arthritis
Prevention
Inflammatory and immune system
Systemic
Evaluation of treatments and therapeutic interventions
medicine.disease
United States
Arthritis & Rheumatology
Blood pressure
business
Zdroj: Clinical rheumatology, vol 37, iss 2
ISSN: 1434-9949
0770-3198
DOI: 10.1007/s10067-017-3860-x
Popis: Despite the increasing use of the 2013 American College of Cardiology/American Heart Association (ACC/AHA) cardiovascular (CV) risk score in clinical practice, few studies have compared this score to the Framingham risk score among rheumatologic patients. We calculated Framingham and 2013 ACC/AHA risk scores in subjects with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) and assessed demographic, CV, and rheumatologic characteristics associated with discordant scores (high-risk ACC/AHA scores but low-risk Framingham scores). SLE and RA subjects drawn from two population-based cohort studies were assessed during in-person study visits. We used chi-squared tests and t tests to examine the association of discordant CV risk scores with baseline characteristics. Eleven (7.0%) of 157 SLE subjects and 11 (11.5%) of 96 RA subjects had discordant CV risk scores with high ACC/AHA scores and low Framingham scores. These findings did not significantly change when a 1.5 multiplier was applied to the Framingham score. Rheumatologic disease duration, high-sensitivity CRP levels, African-American race, diabetes, current use of anti-hypertensive medication, higher age, and higher systolic blood pressure were each significantly associated with discordant risk scores. Approximately 10% of SLE and RA subjects had discordant 10-year CV risk scores. Our findings suggest that the use of the 2013 ACC/AHA risk score could result in changes to lipid-lowering therapy recommendations in a significant number of rheumatologic patients. Prospective studies are needed to compare which score better predicts CV events in rheumatologic patients, especially those with risk factors associated with discordant risk scores.
Databáze: OpenAIRE
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