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Assessment of cardiovascular risk in patients with rheumatoid arthritis using the SCORE risk index
Otávio Augusto Martins de Campos1, Nazaré Otília Nazário2, Sônia Cristina de Magalhães Souza Fialho3
1Discipline of Rheumatology, Universidade do Sul de Santa Catarina, Florianópolis, SC, Brazil.
Insights
Female rheumatoid arthritis patients face a higher 10-year risk of fatal cardiovascular events. The modified SCORE (mSCORE) index, accounting for disease-specific factors, better identifies this elevated cardiovascular risk in RA patients compared to the standard SCORE index.
Area of Science:
- Rheumatology
- Cardiology
- Epidemiology
Background:
- Rheumatoid arthritis (RA) is a systemic autoimmune disease.
- RA is linked to an increased risk of cardiovascular disease (CVD).
Purpose of the Study:
- To assess the 10-year fatal CVD event risk in female RA patients versus controls.
- To compare the predictive accuracy of SCORE and modified SCORE (mSCORE) risk indexes.
Main Methods:
- A case-control study involving 100 female RA patients and 100 matched controls.
- Utilized SCORE and mSCORE risk indexes for 10-year fatal CVD risk prediction.
- Applied mSCORE in RA patients with disease duration ≥10 years, RF/anti-CCP positivity, or extra-articular manifestations.
Main Results:
- Comorbidity prevalence was similar between RA patients and controls.
- SCORE index means were comparable (1.99 in RA vs. 1.56 in controls, p=0.06).
- mSCORE index means were significantly higher in RA patients (2.84 vs. 1.56, p=0.001).
- High-risk classification: 11% by SCORE vs. 36% by mSCORE in RA patients (p<0.001).
Conclusions:
- The standard SCORE index shows similar CVD risk in RA patients and controls.
- The mSCORE index reveals a significantly higher 10-year fatal CVD risk in RA patients.
- Disease-specific factors, captured by mSCORE, are crucial for accurate CVD risk assessment in RA.
Introduction:
Rheumatoid arthritis is an autoimmune disease that causes systemic involvement and is associated with increased risk of cardiovascular disease.
Objective:
To analyze the prediction index of 10-year risk of a fatal cardiovascular disease event in female RA patients versus controls.
Methods:
Case-control study with analysis of 100 female patients matched for age and gender versus 100 patients in the control group. For the prediction of 10-year risk of a fatal cardiovascular disease event, the SCORE and modified SCORE (mSCORE) risk indexes were used, as suggested by EULAR, in the subgroup with two or more of the following: duration of disease ≥10 years, RF and/or anti-CCP positivity, and extra-articular manifestations.
Results:
The prevalence of analyzed comorbidities was similar in RA patients compared with the control group (p>0.05). The means of the SCORE risk index in RA patients and in the control group were 1.99 (SD: 1.89) and 1.56 (SD: 1.87) (p=0.06), respectively. The means of mSCORE index in RA patients and in the control group were 2.84 (SD=2.86) and 1.56 (SD=1.87) (p=0.001), respectively. By using the SCORE risk index, 11% of RA patients were classified as of high risk, and with the use of mSCORE risk index, 36% were at high risk (p<0.001).
Conclusion:
The SCORE risk index is similar in both groups, but with the application of the mSCORE index, we recognized that RA patients have a higher 10-year risk of a fatal cardiovascular disease event, and this reinforces the importance of factors inherent to the disease not measured in the SCORE risk index, but considered in mSCORE risk index.
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Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...