ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP PRSYM
    • 2016-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 2828

The Performance Of The Original and An Updated Cardiovascular Risk Algorithm (SCORE)  In Patients With Rheumatoid Arthritis

Elke.E.A. Arts1, Calin Popa1, Alfons A. den Broeder2, Anne Grete Semb3, Tracey Toms4, George Kitas4, Piet L.C.M. van Riel1 and Jaap Fransen1, 1Rheumatology, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands, 2Rheumatology, Sint Maartenskliniek, Nijmegen, Netherlands, 3Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, 4Rheumatology, Dudley Group of Hospitals NHS Trust, Russells Hall Hospital, Dudley, United Kingdom

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: Cardiovascular disease, rheumatoid arthritis (RA) and risk assessment

  • Tweet
  • Email
  • Print
Session Information

Session Title: Rheumatoid Arthritis - Clinical Aspects VI: Cardiovascular Disease in Rheumatoid Arthritis

Session Type: Abstract Submissions (ACR)

Background/Purpose: Cardiovascular (CV) risk in rheumatoid arthritis (RA) is increased. The CV risk algorithms for the  general population may underestimate the risk of cardiovascular disease (CVD) in RA patients1. The objective of this study was to test the performance of the original and updated SCORE risk algorithm for the prediction of the 10-year risk of CVD in RA patients.

Methods: Data from the Nijmegen early RA inception cohort (n=1017) were used. The systematic coronary risk evaluation algorithm (SCORE) recalibrated for the Dutch population was used as a basis for the new model. This algorithm was recalibrated in this cohort (SCORE recalibrated) by first adjusting the weights of only the risk factors that were included in the original SCORE (age, gender, smoking, systolic blood pressure and total cholesterol:HDL ratio) and in the following this step the original SCORE was updated (SCORE updated) by including other risk factors as assessed in univariate and multivariate Cox proportional hazard regression analysis (significant at p-value <0.2). Predictive performance was assessed by the area under the receiver operating characteristic (ROC) curve and by comparing the observed versus expected number of CV events using Hosmer-Lemeshov tests and calibration plots.

Results: During follow-up, 144 patients had a CV event. In addition to the risk factors of the original SCORE, the updated model included BMI, diabetes, hypertension and high disease activity (DAS28>5.1) at baseline. Areas under the ROC curve were 0.72 (95% CI; 0.68-0.77, 0.71 (0.67-0.75), 0.75 (0.71-0.79), for the original, the recalibrated and the updated SCORE respectively (figure 1A), indicating moderate to good discrimination. The agreement between the observed and the predicted CV events was poor for the original score which underestimated CV risk at low and middle observed risk levels, which was confirmed in the Hosmer and Lemeshow (H-L) test that indicated poor model fit (p< 0.001). The updated SCORE still showed some underestimation (figure 1B) in the low-middle risk groups (≤ 20% CV risk) and overestimation in the highest risk groups, but overall model fit and predictive accuracy improved (H-L test p=1.0).

Conclusion: CV risk predictions according to the updated SCORE risk algorithm were more accurate compared to the original SCORE risk algorithm, particularly in the low and intermediate CV risk groups. The next step will be to externally validate these results in a different cohort.

Figure 1. Panel A: ROC-curves for the different SCORE algorithms. Panel B:  Calibration plot of the updated SCORE. Depicted are the observed events versus predicted events (observed versus predicted probabilities).

References

1.     Crowson CS, Matteson EL, Roger VL, Therneau TM, Gabriel SE. Usefulness of Risk Scores to Estimate the Risk of Cardiovascular Disease in Patients With Rheumatoid Arthritis. Am J Cardiol. 2012.3

 



Disclosure:

E. E. A. Arts,
None;

C. Popa,
None;

A. A. den Broeder,
None;

A. G. Semb,

Merck/Schering-Plough, Abbott, BMS, Pfizer/Wyeth, Genentech and Roche,

5;

T. Toms,
None;

G. Kitas,
None;

P. L. C. M. van Riel,
None;

J. Fransen,
None.

  • Tweet
  • Email
  • Print

« Back to 2013 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-performance-of-the-original-and-an-updated-cardiovascular-risk-algorithm-score-in-patients-with-rheumatoid-arthritis/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2022 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies