MiscellaneousUsefulness of Risk Scores to Estimate the Risk of Cardiovascular Disease in Patients With Rheumatoid Arthritis
Section snippets
Methods
This retrospective, population-based study was conducted using the resources of the Rochester Epidemiology Project, a medical records linkage system that allows ready access to the complete (inpatient and outpatient) medical records from all community medical providers.6 An incidence cohort of all residents of Olmsted County, Minnesota, aged ≥18 years who first fulfilled 1987 American College of Rheumatology classification criteria for RA from January 1, 1988, to December 31, 2007, was
Results
The study included 525 patients with RA aged ≥30 years without previous CVD (mean age 57 years, 69% women) who were followed for a mean of 8.4 years and 524 patients without RA of similar age, gender, and follow-up duration. Table 1 lists the characteristics at the incidence or index date for patients with and without RA.
The general Framingham risk score and the office-based Framingham risk score were calculated. The 2 assessments were similar, but the office-based Framingham risk score yielded
Discussion
The Framingham risk score substantially underestimated CVD risk in patients with RA of both genders, especially in older ages and in patients with positive rheumatoid factor and those with persistently elevated erythrocyte sedimentation rates. This indicates that RA disease severity and inflammation play a role in CVD risk that is not accounted for in the Framingham risk score. In addition, the Reynolds risk score underestimated CVD risk in women with RA, despite its inclusion of C-reactive
References (30)
- et al.
Rochester Epidemiology Project: a unique resource for research in the rheumatic diseases
Rheum Dis Clin North Am
(2004) - et al.
Relation between age and cardiovascular disease in men and women with diabetes compared with non-diabetic people: a population-based retrospective cohort study
Lancet
(2006) - et al.
The Framingham predictive instrument in chronic kidney disease
J Am Coll Cardiol
(2007) - et al.
General cardiovascular risk profile for use in primary care: the Framingham Heart Study
Circulation
(2008) - et al.
Do cardiovascular risk factors confer the same risk for cardiovascular outcomes in rheumatoid arthritis patients as in non-rheumatoid arthritis patients?
Ann Rheum Dis
(2008) - et al.
Lipid paradox in rheumatoid arthritis: the impact of serum lipid measures and systemic inflammation on the risk of cardiovascular disease
Ann Rheum Dis
(2011) - et al.
Cardiovascular morbidity and mortality in patients with rheumatoid arthritis: vascular alterations and possible clinical implications
Q J Med
(2011) - et al.
Development and validation of improved algorithms for the assessment of global cardiovascular risk in women: the Reynolds Risk Score
JAMA
(2007) - et al.
The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis
Arthritis Rheum
(1988) - et al.
Is the incidence of rheumatoid arthritis rising?Results from Olmsted County, Minnesota 1955–2007
Arthritis Rheum
(2010)
Diagnostic criteria for hospitalized acute myocardial infarction: the Minnesota experience
Int J Epidemiol
Noncardiac vascular disease in rheumatoid arthritis: increase in venous thromboembolic events?
Arthritis Rheum
The epidemiology of heart failure: the Framingham Study
J Am Coll Cardiol
Some simple approximate tests for Poisson variates
Biometrika
Cardiovascular risk prediction: basic concepts, current status, and future directions
Circulation
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This work was funded by grants from Pfizer, Inc., New York, New York, and the National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01 AR46849), Bethesda, Maryland, and made possible by the Rochester Epidemiology Project (Grant R01 AG034676 from the National Institute on Aging, Bethesda, Maryland).