External validation of a multi-biomarker-based score for predicting risk of cardiovascular disease in patients with...

Area of Science:

• Rheumatology
• Cardiology
• Biomarker Discovery

Background:

• Rheumatoid arthritis (RA) patients face elevated cardiovascular disease (CVD) risk.
• A multi-biomarker disease activity (MBDA) score was previously developed to predict 3-year CVD risk in RA.
• External validation in a younger RA cohort is necessary.

Purpose of the Study:

• To externally validate the MBDA-based CVD risk score in a younger, independent rheumatoid arthritis cohort.
• To assess the score's predictive performance for myocardial infarction, stroke, or CVD death.
• To determine if the MBDA score adds predictive value to existing clinical risk factors.

Main Methods:

• A cohort of RA patients aged ≥18 years was created by linking claims data to MBDA test results.
• Univariable and multivariable Cox proportional hazards regression models were used to analyze CVD event prediction.
• Hazard ratios (HR) were calculated for the MBDA-based CVD risk score and its incremental value.

Main Results:

• The MBDA-based CVD risk score significantly predicted 3-year CVD events in 49,028 RA patients (HR=3.99, p=5.0x10^-95).
• The score's predictive significance was consistent across various subgroups (age, comorbidities, disease activity, drug use).
• The MBDA score significantly improved prediction when added to clinical data (hypertension, diabetes, smoking, CVD history, age, sex, CRP) (HR=2.27, p=1.7x10^-7).

Conclusions:

• The MBDA-based CVD risk score is externally validated in a younger RA cohort.
• The score demonstrates robust predictive capability for CVD events in RA patients.
• This validated score can enhance cardiovascular risk assessment in rheumatoid arthritis management.