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CVD risk predictors may also indicate subclinical atherosclerotic changes
Five commonly used cardiovascular disease risk prevention scores were significantly associated with vascular function and morphology in patients with rheumatoid arthritis during a 6-year follow-up study.
Of the 400 patients with rheumatoid arthritis (RA) included in the Dudley Rheumatoid Arthritis Comorbidity Cohort, a prospective study specifically examining cardiovascular disease (CVD) risk in patients with RA in 2006, 201 agreed to participate in a follow-up study in 2012.
At baseline, all patients underwent a detailed review of their medical history and records, assessments of physical characteristics such as height and body mass index, body composition and disease activity score. All medications and indications were also recorded.
During the 6-year follow-up visit, researchers assessed the patients’ microvascular endothelium-dependent and endothelium-independent function, as well as carotid atherosclerosis. In addition, the European League Against Rheumatism (EULAR) criteria was applied to the follow-up group, which included disease duration of more than 10 years, rheumatoid factor or anti-citrullinated peptide antibody positivity and presence of some particular extra-articular manifestations. With the exception of QRISK2, patients who met any two of the EULAR criteria had all of their risk scores multiplied by 1.5.
The researchers found Framingham Risk Score increased at follow-up by three points; however, Reynolds risk and SCORE algorithms were similar at each time point. QRISK2 was lower at baseline than at follow-up, and the researchers concluded it was more consistent and ranked as a first choice for predicting three of five CVD risk factors and ranked second for another.
Reynolds risk was ranked highest for macrovascular endothelium-dependent function and carotid atherosclerosis risks. The weakest correlations were seen with SCORE. No significant differences were seen between standard and EULAR-adjusted scores, according to the researchers.
Disclosure: The authors reported no financial disclosures.