Session Information
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose:
Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death in RA. Management and stratification of ASCVD in RA patients is still a matter of debate. Performance of cardiovascular risk calculators, including Framingham Risk Scores (FRS) BMI and Lipids, Reynolds Risk Scale (RRS) and QRISK2 have shown poor results in RA. The recent ACC/AHA 2013 risk calculator (OMNIBUS) has not been compared against the other scales in RA patients.
Methods:
An observational, cross-sectional, prospective study was designed. Patients with RA that fulfilled ACR/EULAR 2010 classification criteria and attended a reference center were included. Cardiovascular risk was calculated by 5 different scales using the official online calculators. Patients with prior ASCVD, overlap syndromes, out of the predefined age range (40-75 years old) or with missing data were excluded.
Sample size was calculated to determine a 5% difference between scales. Friedman test was used to identify difference between the calculators considering a p<0.05 as statistically significant. To determine differences between each algorithm, Wilcoxon signed-rank tests were used and considered significant when p<0.005 due to repeated measurement analysis.
Results:
A total of 93 patients were included. Mean age was 56.8±8.8 years old and mean disease duration of 12.84±8.3 years. Women accounted for 86 (92.6%). The population’s demographical data is shown in Table 1. Friedman test determined a significant difference between the scales (p<0.001). Wilcoxon signed-rank test results are shown in Table 2. RRS estimation was significantly lower than any other calculator (p<0.001). FRS BMI gave higher values than the other algorithms (p<0.001). OMNIBUS risk was lower than FRS Lipids and QRISK2 (p<0.001). There was no difference between QRISK2 and FRS Lipids (p=0.964). OMNIBUS gave higher values than RRS (p<0.001).
Conclusion:
In our cohort of Hispanics with RA, FRS BMI provided higher risk values than any other scale. There was no difference between FRS Lipids and QRISK2 estimations. OMNIBUS stratified patients lower than FRS Lipids and QRISK2. Prospective information is needed to determine if FRS BMI could represent the best option in RA.
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Table 1. Demographical characteristics |
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Age (yo), mean ± SD |
56.8 (8.824) |
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Feminine, n (%) |
86(92.5) |
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Family history of ASCVD, n (%) |
11 (11.8) |
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Current smoking, n (%) |
9 (9.7) |
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Dyslipidemia, n (%) |
28 (30.1) |
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Type 2 Diabetes Mellitus, n (%) |
12 (12.9) |
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Currently on antihypertensive drugs, n (%) |
32 (34.4) |
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Extra articular manifestations, n (%) |
3 (3.2%) |
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Disease duration (yo), mean ± SD |
12.84 (8.32) |
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BMI, mean ± SD |
27.71 (4.70) |
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Systolic BP (mmHg), mean ± SD |
121.07 (13.77) |
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DAS 28-CRP, mean ± SD |
3.492 (1.378) |
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Total cholesterol (mg/dl), mean ± SD |
186.44 (30.26) |
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HDL cholesterol (mg/dl), mean ± SD |
55.62 (17.03) |
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LDL cholesterol (mg/dl), mean ± SD |
100.85 (26.22) |
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TC : HDL ratio, mean ± SD |
3.60 (1.06) |
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hs-CRP (mg/dl), median (p25-p75) |
.96 (.635-1.395) |
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Omnibus (%), median (p25-p75) |
2.8 (1.2-6.2) |
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Framingham lipids (%), median (p25-p75) |
6 (3.3-9.25) |
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Framingham BMI (%), median (p25-p75) |
7.9 (4.4-11.95) |
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QRISK2 (%), median (p25-p75) |
6.2 (2.6-12.35) |
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Reynolds Risk (%), median (p25-p75) |
2 (1-3.5) |
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Table 2. Wilcoxon signed test results |
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Scale Median (p25-p75) |
OMNIBUS 2.8 (1.2-6.2) |
FRS Lipids 6 (3.3-9.25) |
FRS BMI 7.9 (4.4-11.95) |
QRISK2 6.2 (2.6-12.35) |
RRS 2 (1-3.5) |
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OMNIBUS 2.8 (1.2-6.2) |
|
p<.001 |
p<.001 |
p<.001 |
p<.001 |
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FRS Lipids 6 (3.3-9.25) |
p<.001 |
|
p<.001 |
p<.964 |
p<.001 |
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FRS BMI 7.9 (4.4-11.95) |
p<.001 |
p<.001 |
|
p<.001 |
p<.001 |
|
QRISK2 6.2 (2.6-12.35) |
p<.001 |
p<.964 |
p<.001 |
|
p<.001 |
|
RRS 2 (1-3.5) |
p<.001 |
p<.001 |
p<.001 |
p<.001 |
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To cite this abstract in AMA style:
Cardenas-de La Garza A, Vera-Pineda R, Galarza-Delgado DA, Azpiri-Lopez JR, Colunga-Pedraza IJ, Serna-Peña G, Garza-Elizondo MA. Comparison of 5 Cardiovascular Risk Calculators in a Hispanic Rheumatoid Arthritis Cohort [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/comparison-of-5-cardiovascular-risk-calculators-in-a-hispanic-rheumatoid-arthritis-cohort/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/comparison-of-5-cardiovascular-risk-calculators-in-a-hispanic-rheumatoid-arthritis-cohort/