Assessing the validity of QRISK3 in predicting cardiovascular events in systemic lupus erythematosus

ObjectivesTraditional cardiovascular risk calculators such as the Framingham Risk Score (FRS) have been shown to underestimate risk in patients with SLE. The QRISK3 calculator is unique in including SLE and corticosteroid use as risk factors. This study aims to assess the validity of QRISK3 compared...

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Published in:Lupus science & medicine 2022-02, Vol.9 (1), p.e000564
Main Authors: Zhu, Lisa, Singh, Manpreet, Lele, Sonia, Sahakian, Lori, Grossman, Jennifer, Hahn, Bevra, McMahon, Maureen
Format: Article
Language:English
Subjects:
Adult
Biomarkers
Cardiovascular disease
cardiovascular diseases
Cardiovascular Diseases - diagnosis
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - etiology
epidemiology
Epidemiology and Outcomes
High density lipoprotein
Humans
Lupus
lupus erythematosus
Lupus Erythematosus, Systemic - complications
Prospective Studies
Risk Assessment
Risk Factors
systemic
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container_title Lupus science & medicine
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creator Zhu, Lisa
Singh, Manpreet
Lele, Sonia
Sahakian, Lori
Grossman, Jennifer
Hahn, Bevra
McMahon, Maureen
description ObjectivesTraditional cardiovascular risk calculators such as the Framingham Risk Score (FRS) have been shown to underestimate risk in patients with SLE. The QRISK3 calculator is unique in including SLE and corticosteroid use as risk factors. This study aims to assess the validity of QRISK3 compared with other cardiovascular risk models in a cohort of patients with SLE in the USA.MethodsWe studied a prospective cohort of 366 adult patients with SLE without history of any cardiovascular event and followed them for 10 years. We compared the diagnostic performance of QRISK3 with FRS, modified FRS, Atherosclerotic Cardiovascular Disease (ASCVD), and Predictors of Risk for Elevated Flares, Damage Progression and Increased Cardiovascular Disease in Patients with SLE (PREDICTS).ResultsSixty-four of the 366 patients (17.4%) experienced at least one cardiovascular event during the 10-year follow-up period. Of these patients 45% had a QRISK3 score >10%, whereas 20.5% of patients who did not have an event had a QRISK3 score >10% (p10%, FRS >10% and modified FRS >10%.ConclusionsBoth QRISK3 and PREDICTS demonstrated better performance in predicting risk of cardiovascular disease in this cohort of patients with SLE compared with FRS, modified FRS and ASCVD.
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The QRISK3 calculator is unique in including SLE and corticosteroid use as risk factors. This study aims to assess the validity of QRISK3 compared with other cardiovascular risk models in a cohort of patients with SLE in the USA.MethodsWe studied a prospective cohort of 366 adult patients with SLE without history of any cardiovascular event and followed them for 10 years. We compared the diagnostic performance of QRISK3 with FRS, modified FRS, Atherosclerotic Cardiovascular Disease (ASCVD), and Predictors of Risk for Elevated Flares, Damage Progression and Increased Cardiovascular Disease in Patients with SLE (PREDICTS).ResultsSixty-four of the 366 patients (17.4%) experienced at least one cardiovascular event during the 10-year follow-up period. Of these patients 45% had a QRISK3 score &gt;10%, whereas 20.5% of patients who did not have an event had a QRISK3 score &gt;10% (p&lt;0.001). The corresponding numbers for FRS, modified FRS, ASCVD and PREDICTS were 11.0% vs 7.2% (p=ns), 40.6% vs 28.0% (p=0.05), 12.2% vs 5.9% (p=ns), and 77% vs 32.1% (p&lt;0.001), respectively. The areas under the receiver operating characteristic curve using QRISK3 &gt;10% and high-risk PREDICTS were both larger than those using ASCVD &gt;10%, FRS &gt;10% and modified FRS &gt;10%.ConclusionsBoth QRISK3 and PREDICTS demonstrated better performance in predicting risk of cardiovascular disease in this cohort of patients with SLE compared with FRS, modified FRS and ASCVD.</description><identifier>ISSN: 2053-8790</identifier><identifier>EISSN: 2053-8790</identifier><identifier>DOI: 10.1136/lupus-2021-000564</identifier><identifier>PMID: 35193947</identifier><language>eng</language><publisher>England: Lupus Foundation of America</publisher><subject>Adult ; Biomarkers ; Cardiovascular disease ; cardiovascular diseases ; Cardiovascular Diseases - diagnosis ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - etiology ; epidemiology ; Epidemiology and Outcomes ; High density lipoprotein ; Humans ; Lupus ; lupus erythematosus ; Lupus Erythematosus, Systemic - complications ; Prospective Studies ; Risk Assessment ; Risk Factors ; systemic</subject><ispartof>Lupus science &amp; medicine, 2022-02, Vol.9 (1), p.e000564</ispartof><rights>Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2022 Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b531t-dfa0a0af89550eafdf4c696f61e287527acda750ffc36dc1e945e3d8910b953b3</citedby><cites>FETCH-LOGICAL-b531t-dfa0a0af89550eafdf4c696f61e287527acda750ffc36dc1e945e3d8910b953b3</cites><orcidid>0000-0001-9858-7265 ; 0000-0002-2910-7640</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2632236469/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2632236469?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,25731,27901,27902,36989,36990,44566,53766,53768,55325,74869,77403,77429</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35193947$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhu, Lisa</creatorcontrib><creatorcontrib>Singh, Manpreet</creatorcontrib><creatorcontrib>Lele, Sonia</creatorcontrib><creatorcontrib>Sahakian, Lori</creatorcontrib><creatorcontrib>Grossman, Jennifer</creatorcontrib><creatorcontrib>Hahn, Bevra</creatorcontrib><creatorcontrib>McMahon, Maureen</creatorcontrib><title>Assessing the validity of QRISK3 in predicting cardiovascular events in systemic lupus erythematosus</title><title>Lupus science &amp; medicine</title><addtitle>Lupus Sci Med</addtitle><addtitle>Lupus Sci Med</addtitle><description>ObjectivesTraditional cardiovascular risk calculators such as the Framingham Risk Score (FRS) have been shown to underestimate risk in patients with SLE. The QRISK3 calculator is unique in including SLE and corticosteroid use as risk factors. This study aims to assess the validity of QRISK3 compared with other cardiovascular risk models in a cohort of patients with SLE in the USA.MethodsWe studied a prospective cohort of 366 adult patients with SLE without history of any cardiovascular event and followed them for 10 years. We compared the diagnostic performance of QRISK3 with FRS, modified FRS, Atherosclerotic Cardiovascular Disease (ASCVD), and Predictors of Risk for Elevated Flares, Damage Progression and Increased Cardiovascular Disease in Patients with SLE (PREDICTS).ResultsSixty-four of the 366 patients (17.4%) experienced at least one cardiovascular event during the 10-year follow-up period. Of these patients 45% had a QRISK3 score &gt;10%, whereas 20.5% of patients who did not have an event had a QRISK3 score &gt;10% (p&lt;0.001). The corresponding numbers for FRS, modified FRS, ASCVD and PREDICTS were 11.0% vs 7.2% (p=ns), 40.6% vs 28.0% (p=0.05), 12.2% vs 5.9% (p=ns), and 77% vs 32.1% (p&lt;0.001), respectively. The areas under the receiver operating characteristic curve using QRISK3 &gt;10% and high-risk PREDICTS were both larger than those using ASCVD &gt;10%, FRS &gt;10% and modified FRS &gt;10%.ConclusionsBoth QRISK3 and PREDICTS demonstrated better performance in predicting risk of cardiovascular disease in this cohort of patients with SLE compared with FRS, modified FRS and ASCVD.</description><subject>Adult</subject><subject>Biomarkers</subject><subject>Cardiovascular disease</subject><subject>cardiovascular diseases</subject><subject>Cardiovascular Diseases - diagnosis</subject><subject>Cardiovascular Diseases - epidemiology</subject><subject>Cardiovascular Diseases - etiology</subject><subject>epidemiology</subject><subject>Epidemiology and Outcomes</subject><subject>High density lipoprotein</subject><subject>Humans</subject><subject>Lupus</subject><subject>lupus erythematosus</subject><subject>Lupus Erythematosus, Systemic - complications</subject><subject>Prospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>systemic</subject><issn>2053-8790</issn><issn>2053-8790</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>9YT</sourceid><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNp1kktr3DAQgE1paUKaH9BLMfTSi1M9rNelEELaLgmUvs5irMdGi21tJXth_3216zRNCkUHCembTzPDVNVrjC4wpvx9P2_n3BBEcIMQYrx9Vp0SxGgjhULPH51PqvOcN4XBBFMh0cvqhDKsqGrFaWUvc3Y5h3FdT3eu3kEfbJj2dfT112-r7ze0DmO9Tc4GMx0gA8mGuINs5h5S7XZunPKByfs8uSGY-phX7dK--AaYYp7zq-qFhz678_v9rPr58frH1efm9sun1dXlbdMxiqfGekBleakYQw689a3hinuOHZGCEQHGgmDIe0O5NdipljlqpcKoU4x29KxaLV4bYaO3KQyQ9jpC0MeLmNYa0hRM7zSXrBWAFPHUt4I5EEpiDq1CwrXUQHF9WFzbuRucNaXOBP0T6dOXMdzpddxpKbmgBBXBu3tBir9mlyc9hGxc38Po4pw14ZTgliskC_r2H3QT5zSWVh0pQnnhCoUXyqSYc3L-IRmM9GEk9LH1-jASehmJEvPmcRUPEX8GoADNAnTD5u-v_xf-BnIWwuE</recordid><startdate>20220201</startdate><enddate>20220201</enddate><creator>Zhu, Lisa</creator><creator>Singh, Manpreet</creator><creator>Lele, Sonia</creator><creator>Sahakian, Lori</creator><creator>Grossman, Jennifer</creator><creator>Hahn, Bevra</creator><creator>McMahon, Maureen</creator><general>Lupus Foundation of America</general><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>9YT</scope><scope>ACMMV</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-9858-7265</orcidid><orcidid>https://orcid.org/0000-0002-2910-7640</orcidid></search><sort><creationdate>20220201</creationdate><title>Assessing the validity of QRISK3 in predicting cardiovascular events in systemic lupus erythematosus</title><author>Zhu, Lisa ; Singh, Manpreet ; Lele, Sonia ; Sahakian, Lori ; Grossman, Jennifer ; Hahn, Bevra ; McMahon, Maureen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b531t-dfa0a0af89550eafdf4c696f61e287527acda750ffc36dc1e945e3d8910b953b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adult</topic><topic>Biomarkers</topic><topic>Cardiovascular disease</topic><topic>cardiovascular diseases</topic><topic>Cardiovascular Diseases - diagnosis</topic><topic>Cardiovascular Diseases - epidemiology</topic><topic>Cardiovascular Diseases - etiology</topic><topic>epidemiology</topic><topic>Epidemiology and Outcomes</topic><topic>High density lipoprotein</topic><topic>Humans</topic><topic>Lupus</topic><topic>lupus erythematosus</topic><topic>Lupus Erythematosus, Systemic - complications</topic><topic>Prospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>systemic</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhu, Lisa</creatorcontrib><creatorcontrib>Singh, Manpreet</creatorcontrib><creatorcontrib>Lele, Sonia</creatorcontrib><creatorcontrib>Sahakian, Lori</creatorcontrib><creatorcontrib>Grossman, Jennifer</creatorcontrib><creatorcontrib>Hahn, Bevra</creatorcontrib><creatorcontrib>McMahon, Maureen</creatorcontrib><collection>British Medical Journal Open Access Journals</collection><collection>BMJ Journals:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest - Health &amp; 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medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhu, Lisa</au><au>Singh, Manpreet</au><au>Lele, Sonia</au><au>Sahakian, Lori</au><au>Grossman, Jennifer</au><au>Hahn, Bevra</au><au>McMahon, Maureen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Assessing the validity of QRISK3 in predicting cardiovascular events in systemic lupus erythematosus</atitle><jtitle>Lupus science &amp; medicine</jtitle><stitle>Lupus Sci Med</stitle><addtitle>Lupus Sci Med</addtitle><date>2022-02-01</date><risdate>2022</risdate><volume>9</volume><issue>1</issue><spage>e000564</spage><pages>e000564-</pages><issn>2053-8790</issn><eissn>2053-8790</eissn><abstract>ObjectivesTraditional cardiovascular risk calculators such as the Framingham Risk Score (FRS) have been shown to underestimate risk in patients with SLE. The QRISK3 calculator is unique in including SLE and corticosteroid use as risk factors. This study aims to assess the validity of QRISK3 compared with other cardiovascular risk models in a cohort of patients with SLE in the USA.MethodsWe studied a prospective cohort of 366 adult patients with SLE without history of any cardiovascular event and followed them for 10 years. We compared the diagnostic performance of QRISK3 with FRS, modified FRS, Atherosclerotic Cardiovascular Disease (ASCVD), and Predictors of Risk for Elevated Flares, Damage Progression and Increased Cardiovascular Disease in Patients with SLE (PREDICTS).ResultsSixty-four of the 366 patients (17.4%) experienced at least one cardiovascular event during the 10-year follow-up period. Of these patients 45% had a QRISK3 score &gt;10%, whereas 20.5% of patients who did not have an event had a QRISK3 score &gt;10% (p&lt;0.001). The corresponding numbers for FRS, modified FRS, ASCVD and PREDICTS were 11.0% vs 7.2% (p=ns), 40.6% vs 28.0% (p=0.05), 12.2% vs 5.9% (p=ns), and 77% vs 32.1% (p&lt;0.001), respectively. The areas under the receiver operating characteristic curve using QRISK3 &gt;10% and high-risk PREDICTS were both larger than those using ASCVD &gt;10%, FRS &gt;10% and modified FRS &gt;10%.ConclusionsBoth QRISK3 and PREDICTS demonstrated better performance in predicting risk of cardiovascular disease in this cohort of patients with SLE compared with FRS, modified FRS and ASCVD.</abstract><cop>England</cop><pub>Lupus Foundation of America</pub><pmid>35193947</pmid><doi>10.1136/lupus-2021-000564</doi><orcidid>https://orcid.org/0000-0001-9858-7265</orcidid><orcidid>https://orcid.org/0000-0002-2910-7640</orcidid><oa>free_for_read</oa></addata></record>
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subjects Adult
Biomarkers
Cardiovascular disease
cardiovascular diseases
Cardiovascular Diseases - diagnosis
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - etiology
epidemiology
Epidemiology and Outcomes
High density lipoprotein
Humans
Lupus
lupus erythematosus
Lupus Erythematosus, Systemic - complications
Prospective Studies
Risk Assessment
Risk Factors
systemic
title Assessing the validity of QRISK3 in predicting cardiovascular events in systemic lupus erythematosus
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