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Cardiovascular risk score in Rheumatoid Arthritis
Abrar Ahmed Wagan1, Tafazzul E Haque Mahmud2, Aflak Rasheed3
1Dr. Abrar Ahmed Wagan, FCPS (Medicine). Department of Rheumatology, Sheikh Zayed Federal Post Graduate Institute, Lahore, Pakistan.
Insights
QRISK-2 and Framingham risk calculators were compared for cardiovascular risk in Rheumatoid Arthritis (RA) patients. QRISK-2 is recommended for RA patients due to its comprehensive risk factor assessment.
Area of Science:
- Cardiovascular Medicine
- Rheumatology
- Risk Assessment
Background:
- Rheumatoid Arthritis (RA) is associated with increased cardiovascular disease (CVD) risk.
- Accurate CVD risk stratification is crucial for managing RA patients.
- Existing risk calculators may not fully account for RA-specific factors.
Purpose of the Study:
- To compare the 10-year CVD risk scores calculated by QRISK-2 and Framingham Risk Score (FRS) in RA and non-RA subjects.
- To assess the utility and agreement of these two calculators in predicting CVD risk within these populations.
Main Methods:
- A cohort of 106 RA patients and 106 age- and sex-matched non-RA controls were enrolled.
- Demographic data, lipid profiles (Cholesterol, HDL) were collected.
- 10-year CVD risk was calculated using both QRISK-2 and FRS calculators.
Main Results:
- No significant difference in QRISK-2 scores between RA and non-RA groups (p=0.122).
- Framingham Risk Score showed significantly higher scores in the RA group (p=0.001).
- Higher agreement between QRISK-2 and FRS was observed in both groups (Kappa values > 0.618).
Conclusions:
- QRISK-2 is considered more appropriate for cardiovascular risk assessment in RA patients.
- QRISK-2's inclusion of factors like RA, ethnicity, CKD, and atrial fibrillation enhances its suitability.
Objective:
To determine the 10-year Cardiovascular risk score with QRISK-2 and Framingham risk calculators in Rheumatoid Arthritis and Non Rheumatoid Arthritis subjects and asses the usefulness of QRISK-2 and Framingham calculators in both groups.
Methods:
During the study 106 RA and 106 Non RA patients age and sex matched participants were enrolled from outpatient department. Demographic data and questions regarding other study parameters were noted. After 14 hours of fasting 5 ml of venous blood was drawn for Cholesterol and HDL levels, laboratory tests were performed on COBAS c III (ROCHE). QRISK-2 and Framingham risk calculators were used to get individual 10-year CVD risk score.
Results:
In this study the mean age of RA group was (45.1±9.5) for Non RA group (43.7±8.2), with female gender as common. The mean predicted 10-year score with QRISK-2 calculator in RA group (14.2±17.1%) and Non RA group was (13.2±19.0%) with (p-value 0.122). The 10-year score with Framingham risk score in RA group was (12.9±10.4%) and Non RA group was (8.9±8.7%) with (p-value 0.001). In RA group QRISK-2 (24.5%) and FRS (31.1%) cases with predicted score were in higher risk category. The maximum agreement scores between both calculators was observed in both groups (Kappa = 0.618 RA Group; Kappa = 0.671 Non RA Group).
Conclusion:
QRISK-2 calculator is more appropriate as it takes RA, ethnicity, CKD, and Atrial fibrillation as factors in risk assessment score.
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