Performance of the Expanded Cardiovascular Risk Prediction Score for Rheumatoid Arthritis Is Not Superior to the ACC/AHA Risk Calculator
| Autor: | Bozena Möller, T Smedby, Staffan Magnusson, Solbritt Rantapää-Dahlqvist, Solveig Wållberg-Jonsson, Bengt Wahlin, Lena Innala |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Risk medicine.medical_specialty Immunology Population Hyperlipidemias Risk Assessment law.invention Arthritis Rheumatoid 03 medical and health sciences 0302 clinical medicine Rheumatology law Internal medicine medicine Humans Immunology and Allergy In patient Longitudinal Studies Prospective Studies 030212 general & internal medicine education Aged Aged 80 and over Sweden 030203 arthritis & rheumatology education.field_of_study Prediction score business.industry Middle Aged Prognosis medicine.disease Calculator Cardiovascular Diseases Research Design Rheumatoid arthritis Hypertension Female business Risk assessment Algorithms Follow-Up Studies |
| Zdroj: | The Journal of Rheumatology. 46:130-137 |
| ISSN: | 1499-2752 0315-162X |
| DOI: | 10.3899/jrheum.171008 |
| Popis: | Objective.Cardiovascular (CV) risk estimation calculators for the general population do not perform well in patients with rheumatoid arthritis (RA). An RA-specific risk calculator has been developed, but did not perform better than a risk calculator for the general population when validated in a heterogeneous multinational cohort.Methods.In a cohort of patients with new-onset RA from northern Sweden (n = 665), the risk of CV disease was estimated by the Expanded Cardiovascular Risk Prediction Score for Rheumatoid Arthritis (ERS-RA) and the American College of Cardiology/American Heart Association algorithm (ACC/AHA). The ACC/AHA estimation was analyzed, both as crude data and when adjusted according to the recommendations by the European League Against Rheumatism (ACC/AHA × 1.5). ERS-RA was calculated using 2 variants: 1 from patient and physician reports of hypertension (HTN) and hyperlipidemia [ERS-RA (reported)] and 1 from assessments of blood pressure (BP) and blood lipids [ERS-RA (measured)]. The estimations were compared with observed CV events.Results.All variants of risk calculators underestimated the CV risk. Discrimination was good for all risk calculators studied. Performance of all risk calculators was poorer in patients with a high grade of inflammation, whereas ACC/AHA × 1.5 performed best in the high-inflammatory patients. In those patients with an estimated risk of 5–15%, no risk calculator performed well.Conclusion.ERS-RA underestimated the risk of a CV event in our cohort of patients, especially when risk estimations were based on patient or physician reports of HTN and hyperlipidemia instead of assessment of BP and blood lipids. The performance of ERS-RA was no better than that of ACC/AHA × 1.5, and neither performed well in high-inflammatory patients. |
| Databáze: | OpenAIRE |
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