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CVD risk assessment tool improves accuracy for rheumatoid arthritis patients
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Researchers at the Mayo Clinic led an international team to develop a cardiovascular disease risk tool for patients with rheumatoid arthritis who are at a higher risk than the general population.
Results from a study testing the tool’s accuracy were presented at the European League Against Rheumatism (EULAR) 2014 Annual European Congress of Rheumatology.
“All of the research that we have done and that other teams have done with respect to heart disease and rheumatoid arthritis (RA) demonstrate that major predictors of heart disease in this population have to do with RA itself,” Sherine Gabriel, MD, a rheumatologist and epidemiologist at the Mayo Clinic and study co-author, said in a video posted to YouTube regarding the study. “What’s unique about this calculator is that it incorporates RA disease characteristics into the assessment of cardiac risk.”
RA is linked with an increased risk for heart disease — about double that of patients without RA — making screening and intervention efforts crucial for the long-term health and survival of patients with the disorder.
As a result, Gabriel and colleagues created a cardiovascular risk assessment tool for RA patients, called the Transatlantic Cardiovascular Risk Calculator for Rheumatoid Arthritis (ATACC-RA), to better determine which patients are at risk for developing heart disease. Existing heart disease screening tools for the general population, such as SCORE or the Framingham risk assessment, may not be accurate with RA patients, according to Gabriel.
In the study, the ATACC-RA tool was able to accurately predict a greater number of patients at risk compared with the Framingham risk assessment algorithm. Among the 314 participants with RA who went on to develop cardiovascular disease (CVD), the Framingham algorithm predicted 54% of cases and the ATACC-RA predicted 64%, according to Gabriel.
The RA-specific tool takes into account specific features of the disease that are linked to CVD, such as inflammation and increased risk due to treatment regimens.
Patients assessed under the new tool are informed of the chance of developing heart disease over the next 10 years. Early risk detection is expected to help patients improve overall outcome by seeking treatment with a cardiologist before significant disease progression.
The ATACC-RA tool may also be useful with other inflammatory diseases, such as psoriatic arthritis and lupus, Gabriel said. The researchers plan to continue to further validate the assessment tool and determine methods to personalize its risk scale.
Disclosure: The authors have no relevant financial disclosures.
Reference: AR International. Presented at: European League Against Rheumatism 2014 Annual European Congress of Rheumatology; June 11-14, 2014; Paris; doi:10.1136/annrheumdis-2014-eular.1712.