RT Journal Article
SR Electronic
T1 Predictive utility of cardiovascular risk prediction algorithms in inflammatory rheumatic diseases: A systematic review
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.190261
DO 10.3899/jrheum.190261
A1 Keith Colaco
A1 Vanessa Ocampo
A1 Ana Patricia  Ayala
A1 Paula Harvey
A1 Dafna Gladman
A1 Vincent Piguet
A1 Lihi Eder
YR 2019
UL http://www.jrheum.org/content/early/2019/08/08/jrheum.190261.abstract
AB Objective We performed a systematic review of the literature to describe current knowledge of cardiovascular risk prediction algorithms in rheumatic diseases. Methods A systematic search of MEDLINE, EMBASE, and Cochrane Central databases was performed. The search was restricted to original publications in English, had to include clinical cardiovascular events as study outcomes, assess the predictive properties of at least one cardiovascular risk prediction algorithm, and include patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS), systemic lupus erythematosus (SLE), psoriatic arthritis (PsA) or psoriasis. By design, only cohort studies that followed participants for cardiovascular events were selected. Results Eleven of 146 identified manuscripts were included. Studies evaluated the predictive performance of the Framingham Risk Score, QRISK2, SCORE, Reynolds Risk Score, PCE, Expanded cardiovascular Risk Score for RA (ERS-RA), and the Italian Progetto CUORE score. Approaches to improve predictive performance of general risk algorithms in RA patients included the use of multipliers, biomarkers, disease-specific variables, or a combination of these to modify or develop an algorithm. In both SLE and PsA patients, multipliers were applied to general risk algorithms. In studies of RA and SLE patients, efforts to include non-traditional risk factors, disease-related variables, multipliers and biomarkers largely failed at substantially improving risk estimates. Conclusion Our study confirmed that general risk algorithms mostly underestimate and at times overestimate cardiovascular risk in rheumatic patients. We did not find studies that evaluated models for psoriasis or AS, which further demonstrates a need for research in these populations.