Assessment of cardiovascular risk tools as predictors of cardiovascular disease events in systemic lupus erythematosus

Author:

Sivakumaran Jagan,Harvey Paula,Omar Ahmed,Tayer-Shifman Oshrat,Urowitz Murray BORCID,Gladman Dafna D,Anderson Nicole,Su Jiandong,Touma ZahiORCID

Abstract

BackgroundSLE is an independent risk factor for cardiovascular disease (CVD). This study aimed to determine which among QRISK2, QRISK3, Framingham Risk Score (FRS), modified Framingham Risk Score (mFRS) and SLE Cardiovascular Risk Equation (SLECRE) best predicts CVD.MethodsThis is a single-centre analysis on 1887 patients with SLE followed prospectively according to a standard protocol. Tools’ scores were evaluated against CVD development at/within 10 years for patients with CVD and without CVD. For patients with CVD, the index date for risk score calculation was chosen as close to 10 years prior to CVD event. For patients without CVD, risk scores were calculated as close to 10 years prior to the most recent clinic appointment. Proportions of low-risk (<10%), intermediate-risk (10%–20%) and high-risk (>20%) patients for developing CVD according to each tool were determined, allowing sensitivity, specificity, positive/negative predictive value and concordance (c) statistics analysis.ResultsAmong 1887 patients, 232 CVD events occurred. QRISK2 and FRS, and QRISK3 and mFRS, performed similarly. SLECRE classified the highest number of patients as intermediate and high risk. Sensitivities and specificities were 19% and 93% for QRISK2, 22% and 93% for FRS, 46% and 83% for mFRS, 47% and 78% for QRISK3, and 61% and 64% for SLECRE. Tools were similar in negative predictive value, ranging from 89% (QRISK2) to 92% (SLECRE). FRS and mFRS had the greatest c-statistics (0.73), while QRISK3 and SLECRE had the lowest (0. 67).ConclusionmFRS was superior to FRS and was not outperformed by the QRISK tools. SLECRE had the highest sensitivity but the lowest specificity. mFRS is an SLE-adjusted practical tool with a simple, intuitive scoring system reasonably appropriate for ambulatory settings, with more research needed to develop more accurate CVD risk prediction tools in this population.

Funder

The Kathi and Peter Kaiser Family, the Lou and Marissa Rocca Family and the Bozzo Family

Lupus Foundation of America Gina M Finzi Student Fellowship

Publisher

BMJ

Subject

Immunology,General Medicine

Cited by 22 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Personalizing cardiovascular risk prediction for patients with systemic lupus erythematosus;Seminars in Arthritis and Rheumatism;2024-08

2. Cardio-Rheumatology Insights Into Hypertension: Intersection of Inflammation, Arteries, and Heart;American Journal of Hypertension;2024-07-26

3. Autoimmune diseases and atherosclerotic cardiovascular disease;Nature Reviews Cardiology;2024-06-27

4. Cardiovascular Risk Assessment Scores: A Narrative Review;Journal of the Practice of Cardiovascular Sciences;2024-05

5. Vascular damage in systemic lupus erythematosus;Nature Reviews Nephrology;2024-01-03

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3