Assessing the validity of QRISK3 in predicting cardiovascular events in systemic lupus erythematosus
Objectives Traditional cardiovascular risk calculators such as the Framingham Risk Score (FRS) have been shown to underestimate risk in patients with SLE. The QRISK3 calculator is unique in including SLE and corticosteroid use as risk factors. This study aims to assess the validity of QRISK3 compare...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-07-01
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| Series: | Lupus Science and Medicine |
| Online Access: | https://lupus.bmj.com/content/9/1/e000564.full |
| _version_ | 1797779792942071808 |
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| author | Manpreet Singh Maureen McMahon Jennifer Grossman Lori Sahakian Bevra Hahn Lisa Zhu Sonia Lele |
| author_facet | Manpreet Singh Maureen McMahon Jennifer Grossman Lori Sahakian Bevra Hahn Lisa Zhu Sonia Lele |
| author_sort | Manpreet Singh |
| collection | DOAJ |
| description | Objectives Traditional cardiovascular risk calculators such as the Framingham Risk Score (FRS) have been shown to underestimate risk in patients with SLE. The QRISK3 calculator is unique in including SLE and corticosteroid use as risk factors. This study aims to assess the validity of QRISK3 compared with other cardiovascular risk models in a cohort of patients with SLE in the USA.Methods We studied a prospective cohort of 366 adult patients with SLE without history of any cardiovascular event and followed them for 10 years. We compared the diagnostic performance of QRISK3 with FRS, modified FRS, Atherosclerotic Cardiovascular Disease (ASCVD), and Predictors of Risk for Elevated Flares, Damage Progression and Increased Cardiovascular Disease in Patients with SLE (PREDICTS).Results Sixty-four of the 366 patients (17.4%) experienced at least one cardiovascular event during the 10-year follow-up period. Of these patients 45% had a QRISK3 score >10%, whereas 20.5% of patients who did not have an event had a QRISK3 score >10% (p<0.001). The corresponding numbers for FRS, modified FRS, ASCVD and PREDICTS were 11.0% vs 7.2% (p=ns), 40.6% vs 28.0% (p=0.05), 12.2% vs 5.9% (p=ns), and 77% vs 32.1% (p<0.001), respectively. The areas under the receiver operating characteristic curve using QRISK3 >10% and high-risk PREDICTS were both larger than those using ASCVD >10%, FRS >10% and modified FRS >10%.Conclusions Both QRISK3 and PREDICTS demonstrated better performance in predicting risk of cardiovascular disease in this cohort of patients with SLE compared with FRS, modified FRS and ASCVD. |
| first_indexed | 2024-03-12T23:34:49Z |
| format | Article |
| id | doaj.art-68547a092f3f475ea79816a4907e43ca |
| institution | Directory Open Access Journal |
| issn | 2053-8790 |
| language | English |
| last_indexed | 2024-03-12T23:34:49Z |
| publishDate | 2022-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Lupus Science and Medicine |
| spelling | doaj.art-68547a092f3f475ea79816a4907e43ca2023-07-15T12:30:06ZengBMJ Publishing GroupLupus Science and Medicine2053-87902022-07-019110.1136/lupus-2021-000564Assessing the validity of QRISK3 in predicting cardiovascular events in systemic lupus erythematosusManpreet Singh0Maureen McMahon1Jennifer Grossman2Lori Sahakian3Bevra Hahn4Lisa Zhu5Sonia Lele6Medicine, University of California Los Angeles, Los Angeles, California, USAMedicine - Rheumatology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USAMedicine - Rheumatology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USAMedicine - Rheumatology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USAMedicine - Rheumatology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USAMedicine - Rheumatology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USAMedicine, University of California Los Angeles, Los Angeles, California, USAObjectives Traditional cardiovascular risk calculators such as the Framingham Risk Score (FRS) have been shown to underestimate risk in patients with SLE. The QRISK3 calculator is unique in including SLE and corticosteroid use as risk factors. This study aims to assess the validity of QRISK3 compared with other cardiovascular risk models in a cohort of patients with SLE in the USA.Methods We studied a prospective cohort of 366 adult patients with SLE without history of any cardiovascular event and followed them for 10 years. We compared the diagnostic performance of QRISK3 with FRS, modified FRS, Atherosclerotic Cardiovascular Disease (ASCVD), and Predictors of Risk for Elevated Flares, Damage Progression and Increased Cardiovascular Disease in Patients with SLE (PREDICTS).Results Sixty-four of the 366 patients (17.4%) experienced at least one cardiovascular event during the 10-year follow-up period. Of these patients 45% had a QRISK3 score >10%, whereas 20.5% of patients who did not have an event had a QRISK3 score >10% (p<0.001). The corresponding numbers for FRS, modified FRS, ASCVD and PREDICTS were 11.0% vs 7.2% (p=ns), 40.6% vs 28.0% (p=0.05), 12.2% vs 5.9% (p=ns), and 77% vs 32.1% (p<0.001), respectively. The areas under the receiver operating characteristic curve using QRISK3 >10% and high-risk PREDICTS were both larger than those using ASCVD >10%, FRS >10% and modified FRS >10%.Conclusions Both QRISK3 and PREDICTS demonstrated better performance in predicting risk of cardiovascular disease in this cohort of patients with SLE compared with FRS, modified FRS and ASCVD.https://lupus.bmj.com/content/9/1/e000564.full |
| spellingShingle | Manpreet Singh Maureen McMahon Jennifer Grossman Lori Sahakian Bevra Hahn Lisa Zhu Sonia Lele Assessing the validity of QRISK3 in predicting cardiovascular events in systemic lupus erythematosus Lupus Science and Medicine |
| title | Assessing the validity of QRISK3 in predicting cardiovascular events in systemic lupus erythematosus |
| title_full | Assessing the validity of QRISK3 in predicting cardiovascular events in systemic lupus erythematosus |
| title_fullStr | Assessing the validity of QRISK3 in predicting cardiovascular events in systemic lupus erythematosus |
| title_full_unstemmed | Assessing the validity of QRISK3 in predicting cardiovascular events in systemic lupus erythematosus |
| title_short | Assessing the validity of QRISK3 in predicting cardiovascular events in systemic lupus erythematosus |
| title_sort | assessing the validity of qrisk3 in predicting cardiovascular events in systemic lupus erythematosus |
| url | https://lupus.bmj.com/content/9/1/e000564.full |
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