Combined use of QRISK3 and SCORE as predictors of carotid plaques in patients with rheumatoid arthritis

Corrales, Alfonso; Vegas-Revenga, N.; Atienza‐Mateo, Belén; Corrales-Selaya, Cristina; Prieto-Peña, D.; Rueda-Gotor, Javier; Portilla, Virginia; Blanco, Ricardo; Castañeda, Santos; Ferraz-Amaro, Iván; Llorca, Javier

doi:10.1093/rheumatology/keaa718

Cited by 19 publications

(13 citation statements)

References 24 publications

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“…Our data showed that FRS and QRISK3 can be used in gout patients in future clinical practice. With respect to this, a recent study proposed the combined use of QRISK3 and EULAR-modified SCORE2 as an alternative to the assessment of carotid plaques by ultrasound to identify patients with rheumatoid arthritis at high risk of cardiovascular disease ( 30 ). Therefore, it could be an option to be assessed in patients with gout when an ultrasound study is not available.…”

Section: Discussionmentioning

confidence: 99%

Presence of tophi and carotid plaque were risk factors of MACE in subclinical artherosclerosis patients with gout: a longitudinal cohort study

et al. 2023

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BackgroundPatients with gout carry an excess risk for cardiovascular disease (CVD), but the contribution of subclinical atherosclerosis to the CVD risk has never been reported. In this study, we aimed to explore the predictive factors for incident major adverse cardiovascular events (MACE) in gout patients without a previous history of CVD or cerebral vascular disease.MethodsA single-center, long-term follow-up cohort analysis was performed to assess subclinical atherosclerosis at baseline since 2008. Patients with a previous history of CVD or cerebrovascular disease were excluded. The outcome of the study was the first MACE. The presence of subclinical atherosclerosis was assessed by carotid plaque (CP), and carotid intima-media thickness (CMIT) was determined by ultrasound. An ultrasound scan of bilateral feet and ankles was performed at baseline. The association between tophi, carotid atherosclerosis, and the risk of developing incident MACE was evaluated using Cox proportional hazards models with adjustment for the CVD risk scores.ResultsA total of 240 consecutive patients with primary gout were recruited. Their mean age was 44.0 years, with male predominance (238, 99.2%). During a median follow-up of 10.3 years, incident MACE was ascertained in 28 (11.7%) patients. In a Cox hazards model, controlling for the CV risk scores, the presence of at least two tophi (HR, 2.12–5.25, p < 0.05) and carotid plaque (HR, 3.72–4.01, p < 0.05) were identified as independent predictors of incident MACE in gout patients.ConclusionsThe presence of at least two tophi and carotid plaque on an ultrasound could independently predict MACE in addition to conventional cardiovascular risk factors in gout patients.

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Section: Discussionmentioning

confidence: 99%

Presence of tophi and carotid plaque were risk factors of MACE in subclinical artherosclerosis patients with gout: a longitudinal cohort study

et al. 2023

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“…Combining the QRISK3 and the EULAR modified systematic coronary risk evaluation (mSCORE) algorithms may further optimize the identification of people with rheumatoid arthritis (RA) at high risk for carotid plaques [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular Risk Prediction Parameters for Better Management in Rheumatic Diseases

et al. 2022

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The early detection of cardiovascular disease (CVD) serves as a key element in preventive cardiology. The risk of developing CVD in patients with rheumatic disease is higher than that of the general population. Thus, the objective of this narrative review was to assess and describe updated risk-prediction parameters for CVD in patients suffering from rheumatic diseases, and, additionally, to evaluate therapeutic and risk management possibilities. The processes of recognizing CVD risk factors in rheumatic diseases, establishing diagnoses, and discovering CV risk assessments are currently displeasing in clinical practice; they have a limited clinical impact. A large number of references were found while screening PUBMED, Scopus, and Google scholar databases; the 47 most relevant references were utilized to build up this study. The selection was limited to English language full text articles, RCTs, and reviews published between 2011 and 2021. Multiple imaging techniques, such as ECG, ultrasound, and cIMT, as well as biomarkers like osteoprotegerin cytokine receptor and angiopoietin-2, can be beneficial in both CV risk prediction and in early subclinical diagnosis. Physical exercise is an essential non-pharmacological intervention that can maintain the health of the cardiovascular system and, additionally, influence the underlying disease. Lipid-lowering drugs (methotrexate from the non-biologic DMARDs family as well as biologic DMARDs such as anti-TNF) were all associated with a lower CV risk; however, anti-TNF medication can decrease cardiac compliance and promote heart failure in patients with previously diagnosed chronic HF. Although they achieved success rates in reducing inflammation, glucocorticoids, NSAIDs, and COX-2 inhibitors were correlated with an increased risk of CVD. When taking all of the aforementioned points into consideration, there appears to be a dire need to establish and implement CVD risk stratification models in rheumatic patients.

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“…The QRISK3 algorithm calculates a person’s risk of developing a heart attack or stroke over the next 10 years. It displays the typical risk of individuals who share the same risk factors as those entered for that individual ( 23 ). In addition, QRISK3 was widely used to estimate CVD risk in SLE and RA ( 23 , 24 ).…”

Section: Discussionmentioning

confidence: 99%

“…It displays the typical risk of individuals who share the same risk factors as those entered for that individual ( 23 ). In addition, QRISK3 was widely used to estimate CVD risk in SLE and RA ( 23 , 24 ). However, only a few studies reported the performances of QRSKI3 in calculating CVD risk related to T2DM ( 25 , 26 ).…”

Section: Discussionmentioning

confidence: 99%

Assessment of QRISK3 as a predictor of cardiovascular disease events in type 2 diabetes mellitus

et al. 2022

Front. Endocrinol.

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BackgroundThe risk of cardiovascular disease (CVD) in diabetes mellitus (DM) patients is two- to three-fold higher than in the general population. We designed a 10-year cohort trial in T2DM patients to explore the performance of QRESEARCH risk estimator version 3 (QRISK3) as a CVD risk assessment tool and compared to Framingham Risk Score (FRS).MethodThis is a single-center analysis of prospective data collected from 566 newly-diagnosed patients with type 2 DM (T2DM). The risk scores were compared to CVD development in patients with and without CVD. The risk variables of CVD were identified using univariate analysis and multivariate cox regression analysis. The number of patients classified as low risk (<10%), intermediate risk (10%-20%), and high risk (>20%) for two tools were identified and compared, as well as their sensitivity, specificity, positive and negative predictive values, and consistency (C) statistics analysis.ResultsAmong the 566 individuals identified in our cohort, there were 138 (24.4%) CVD episodes. QRISK3 classified most CVD patients as high risk, with 91 (65.9%) patients. QRISK3 had a high sensitivity of 91.3% on a 10% cut-off dichotomy, but a higher specificity of 90.7% on a 20% cut-off dichotomy. With a 10% cut-off dichotomy, FRS had a higher specificity of 89.1%, but a higher sensitivity of 80.1% on a 20% cut-off dichotomy. Regardless of the cut-off dichotomy approach, the C-statistics of QRISK3 were higher than those of FRS.ConclusionQRISK3 comprehensively and accurately predicted the risk of CVD events in T2DM patients, superior to FRS. In the future, we need to conduct a large-scale T2DM cohort study to verify further the ability of QRISK3 to predict CVD events.

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Combined use of QRISK3 and SCORE as predictors of carotid plaques in patients with rheumatoid arthritis

Cited by 19 publications

References 24 publications

Presence of tophi and carotid plaque were risk factors of MACE in subclinical artherosclerosis patients with gout: a longitudinal cohort study

Presence of tophi and carotid plaque were risk factors of MACE in subclinical artherosclerosis patients with gout: a longitudinal cohort study

Cardiovascular Risk Prediction Parameters for Better Management in Rheumatic Diseases

Assessment of QRISK3 as a predictor of cardiovascular disease events in type 2 diabetes mellitus

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