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Published on: September 26, 2018
Utilizing Clinical and Non-clinical Patient Factors in Predicting Cardiovascular Events in Patients on JAK Inhibitor
Kehinde O Sunmboye1,2, Tom Petrie2, Billy Bui3
1Rheumatology, College of Health Sciences, University of Leicester, Leicester, GBR.
Insights
Age and socioeconomic status effectively predict cardiovascular events in patients with autoimmune rheumatic diseases (ARDs) treated with Janus kinase (JAK) inhibitors. This combined approach aids in identifying high-risk individuals for targeted interventions.
Area of Science:
- Rheumatology
- Cardiology
- Public Health
Background:
- Patients with autoimmune rheumatic diseases (ARDs) on Janus kinase (JAK) inhibitors face elevated cardiovascular event risks, particularly with comorbidities.
- Proactive identification of high-risk patients is crucial for implementing targeted preventive strategies.
Purpose of the Study:
- To evaluate the predictive capability of age and deprivation decile for cardiovascular events in ARD patients undergoing JAK inhibitor therapy.
- To determine if combining age and deprivation decile enhances cardiovascular risk prediction in this population.
Main Methods:
- A cross-sectional cohort study included 309 ARD patients treated with JAK inhibitors at a UK hospital.
- Baseline data, including age, comorbidities, and socioeconomic factors (for deprivation indices), were collected.
- Cardiovascular events (myocardial infarction, stroke, cardiovascular death) were retrospectively identified.
Main Results:
- A combined model of age and deprivation decile significantly predicted cardiovascular events (p = 0.031).
- Neither age nor deprivation decile alone reached statistical significance.
- The model demonstrated strong predictive performance with an Area Under the Curve (AUC) of 0.837.
Conclusions:
- Age and deprivation decile are effective predictors of cardiovascular events in ARD patients on JAK inhibitors.
- Integrating these factors into clinical practice can guide intensified cardiovascular risk management for high-risk individuals.
Background:
Patients with autoimmune rheumatic diseases (ARDs) taking JAK inhibitors may have an increased risk of cardiovascular events, especially if they have other health conditions. Identifying high-risk patients can inform targeted preventive care. This study assessed the value of age and deprivation decile in predicting cardiovascular events in patients on JAK inhibitors for ARDs.
Objective:
To assess the predictive value of age and deprivation decile in identifying patients at risk of cardiovascular events while on JAK inhibitor therapy for ARDs.
Methods:
This cross-sectional cohort study enrolled 309 patients with ARDs (mean age 59.3 years, 77% female) treated with JAK inhibitors at a UK teaching hospital. Baseline characteristics, including age, gender, ethnicity, and comorbidities, were collected. Cardiovascular events (myocardial infarctions, strokes, and cardiovascular-related deaths) that occurred while on JAK inhibitor therapy were identified retrospectively. Deprivation indices were calculated using socioeconomic factors.
Results:
Multivariate logistic regression analysis, adjusting for potential confounders, showed that a model combining age and deprivation decile was statistically significant (p = 0.031) in predicting cardiovascular events. Neither age nor deprivation decile alone was statistically significant. Older patients had an odds ratio of 1.06 (95% CI: 1.00-1.13) for increased risk of cardiovascular events. The logistic regression model as a whole was statistically significant (Chi2(14) = 24.04, p = 0.031, n = 309). The AUC of the ROC curve was 0.837.
Conclusion:
Age and deprivation decile can effectively predict cardiovascular events in patients on JAK inhibitor therapy for ARDs. Incorporating these predictive tools into routine clinical practice can help identify patients who warrant intensified cardiovascular risk management.
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