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General risk algorithms inaccurately predict CV risk in rheumatic patients

01 Jul 2020

Cardiovascular (CV) risk prediction algorithms tend to be inaccurate, frequently underestimating and sometimes overestimating the risk of CV in patients with inflammatory rheumatic diseases, a recent study has shown.

The investigators systematically searched the databases of Embase, Medline, and Cochrane Central for studies that were originally published in English, included clinical CV events as outcomes, examined the predictive properties of at least one CV risk prediction algorithm, and included patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS), systemic lupus erythematosus (SLE), psoriatic arthritis (PsA), or psoriasis. By design, only cohort studies following participants for CV events were included.

Of the 146 manuscripts identified, only 11 were included. Eligible studies assessed the predictive performance of the following: Framingham Risk Score, QRISK2, Systematic Coronary Risk Evaluation, Reynolds Risk Score, American College of Cardiology/American Heart Association Pooled Cohort Equations, Expanded Cardiovascular Risk Prediction Score for Rheumatoid Arthritis, and the Italian Progetto CUORE score.

Approaches, such as the use of multipliers, biomarkers, disease-specific variables, or a combination of these to modify or develop an algorithm, were applied to improve the predictive performance of general risk algorithms in RA patients. For instance, multipliers were employed in general risk algorithms in both SLE and PsA patients.

Additionally, efforts to include nontraditional risk factors, disease-related variables, multipliers, and biomarkers in studies of RA and SLE patients did not succeed in significantly improving risk estimate.

“We did not find studies that evaluated models for psoriasis or AS, which further demonstrates a need for research in these populations,” the investigators said.

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Most Read Articles
Elaine Soliven, 4 days ago

Switching from efavirenz/emtricitabine/tenofovir disoproxil fumarate (EFV/FTC/TDF) to the new bictegravir/ emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) regimen maintained high rates of virological suppression in adults who are living with HIV*, according to a study presented at AIDS 2020.

3 days ago
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Stephen Padilla, 5 days ago
Pre-exposure prophylaxis (PrEP) containing either long-acting injectable cabotegravir (CAB) or tenofovir/emtricitabine (TDF/FTC) is safe and effective for transgender women (TGW) and cisgender men who have sex with men (MSM), but CAB results in a much lower HIV incidence compared to TDF/FTC, results of the HIV Prevention Trials Network (HPTN) 083 have shown.
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Monthly prophylaxis with the fixed-dose combination of naphthoquine-azithromycin (NQAZ) is well tolerated and confers significant protection against infection with Plasmodium parasites among individuals residing in malaria-endemic areas in Southeast Asia, as shown in the results of a phase III trial.