The 2013 ACC/AHA 10-year atherosclerotic cardiovascular disease risk index is better than SCORE and QRisk II in rheumatoid arthritis: is it enough?

Gulsen Ozen; Murat Sunbul; Pamir Atagunduz; Haner Direskeneli; Kursat Tigen; Nevsun Inanc

doi:10.1093/rheumatology/kev363

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The 2013 ACC/AHA 10-year atherosclerotic cardiovascular disease risk index is better than SCORE and QRisk II in rheumatoid arthritis: is it enough?

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Peer reviewed

The 2013 ACC/AHA 10-year atherosclerotic cardiovascular disease risk index is better than SCORE and QRisk II in rheumatoid arthritis: is it enough?

Gulsen Ozen, Murat Sunbul, Pamir Atagunduz, Haner Direskeneli, Kursat Tigen and Nevsun Inanc

Rheumatology (Oxford, England), Vol.55(3), pp.513-522

03/01/2016

DOI: 10.1093/rheumatology/kev363

PMID: 26472565

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Abstract

To determine the ability of the new American College of Cardiology and American Heart Association (ACC/AHA) 10-year atherosclerotic cardiovascular disease (ASCVD) risk algorithm in detecting high cardiovascular (CV) risk, RA patients identified by carotid ultrasonography (US) were compared with Systematic Coronary Risk Evaluation (SCORE) and QRisk II algorithms. SCORE, QRisk II, 2013 ACC/AHA 10-year ASCVD risk and EULAR recommended modified versions were calculated in 216 RA patients. In sonographic evaluation, carotid intima-media thickness >0.90 mm and/or carotid plaques were used as the gold standard test for subclinical atherosclerosis and high CV risk (US+). Eleven (5.1%), 15 (6.9%) and 44 (20.4%) patients were defined as having high CV risk according to SCORE, QRisk II and ACC/AHA 10-year ASCVD risk, respectively. Fifty-two (24.1%) patients were US + and of those, 8 (15.4%), 7 (13.5%) and 23 (44.2%) patients were classified as high CV risk according to SCORE, QRisk II and ACC/AHA 10-year ASCVD risk, respectively. The ACC/AHA 10-year ASCVD risk index better identified US + patients than SCORE and QRisk II (P < 0.0001). With EULAR modification, reclassification from moderate to high risk occurred only in two, five and seven patients according to SCORE, QRisk II and ACC/AHA 10-year ASCVD risk, respectively. The 2013 ACC/AHA 10-year ASCVD risk estimator was better than the SCORE and QRisk II indices in RA, but still failed to identify 55% of high risk patients. Furthermore adjustment of threshold and EULAR modification did not work well.

Adult

Age Distribution

Aged

Algorithms

American Heart Association

Analysis of Variance

Arthritis, Rheumatoid - complications

Arthritis, Rheumatoid - diagnosis

Carotid Artery Diseases - epidemiology

Carotid Artery Diseases - etiology

Carotid Artery Diseases - physiopathology

Carotid Intima-Media Thickness

Coronary Artery Disease - epidemiology

Coronary Artery Disease - etiology

Coronary Artery Disease - physiopathology

Cross-Sectional Studies

Female

Humans

Incidence

Male

Middle Aged

Predictive Value of Tests

Retrospective Studies

Risk Assessment

Severity of Illness Index

Sex Distribution

Societies, Medical

Statistics, Nonparametric

United States

Details

Title: Subtitle: The 2013 ACC/AHA 10-year atherosclerotic cardiovascular disease risk index is better than SCORE and QRisk II in rheumatoid arthritis: is it enough?
Creators: Gulsen Ozen - Marmara University
Murat Sunbul - Marmara University
Pamir Atagunduz - Marmara University
Haner Direskeneli - Marmara University
Kursat Tigen - Marmara University
Nevsun Inanc - Marmara University
Resource Type: Journal article
Publication Details: Rheumatology (Oxford, England), Vol.55(3), pp.513-522
DOI: 10.1093/rheumatology/kev363
PMID: 26472565
ISSN: 1462-0324
eISSN: 1462-0332
Language: English
Date published: 03/01/2016
Academic Unit: Internal Medicine
Record Identifier: 9984702895702771

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