Investigating the Agreement Between Cardiovascular Disease Risk Calculators Among People Diagnosed With Schizophrenia

Area of Science:

• Clinical Medicine
• Psychiatry
• Cardiology

Background:

• Individuals with schizophrenia face significantly reduced life expectancy and a doubled risk of cardiovascular disease (CVD).
• Cardiovascular disease risk calculators are crucial for identifying high-risk individuals and guiding interventions.
• Schizophrenia poses unique challenges in accurately assessing CVD risk.

Purpose of the Study:

• To compare the performance of four distinct CVD risk calculators in a cohort of schizophrenia patients.
• To evaluate the discrepancies in 10-year predicted CVD risk scores across different models.

Main Methods:

• A sample of 30 individuals diagnosed with schizophrenia spectrum disorders was recruited from Greater Manchester, UK.
• Ten-year predicted CVD risk was calculated using QRISK3, Framingham, PRIMROSE BMI, and PRIMROSE lipid models.
• Risk estimates and classifications were compared between the four models.

Main Results:

• QRISK3 identified 39% of participants as having >10% 10-year CVD risk, with 14% exceeding 20%.
• The Framingham model identified 14% with >10% risk, while PRIMROSE models identified no participants above this threshold.
• Significant variability was observed in risk predictions, with concordance correlation coefficients ranging from 0.22 to 0.77. QRISK3 indicated a mean "Heart age" of 58 years for participants averaging 40 years.

Conclusions:

• Existing CVD risk calculators produce divergent risk predictions for schizophrenia patients.
• The choice of risk calculator can lead to different clinical management and treatment recommendations.
• Clinicians must consider patient-specific factors, including preferences and comorbidities, alongside calculator outputs for informed decision-making.