Author, Year | Objective(s) | Evaluated Algorithms | C-statistics | Other Statistics | Major Findings |
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Alemao 201738 | To compare the performance of FRS and QRISK2 in RA and matched non-RA patients, and to evaluate whether their performance could be enhanced by the addition of CRP | FRS FRS + CRP QRISK2 QRISK2 + CRP | 0.764 0.767 0.764 0.765 | FRS + CRP: NRI = 3.2% (95% CI: −2.8, 5.7) QRISK2 + CRP: NRI = −2.0% (95% CI: −5.8, 4.5) |
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Arts 2015 35 | To assess the predictive ability of 4 established CV risk models for the 10-year risk of fatal and non-fatal CV diseases in European patients with RA | FRS QRISK2 RRS SCORE | 0.80 0.79 0.78 0.78 | The FRS, RRS, and SCORE underestimated risk of future CV events, while QRISK2 overestimated risk. | |
Arts 2016 36 | To adapt SCORE with determinants of CV risk in RA patients and to compare the performance of the modified SCORE to the original SCORE regarding CV risk prediction in patients with RA | SCORE Recalibrated SCORE Adapted SCORE | 0.78 0.78 0.80 |
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Crowson 201233 | To assess the accuracy of the FRS and RRS for predicting CV events in patients with RA | FRS (overall) FRS (low risk) FRS (intermediate risk) | 0.786 0.562 0.505 |
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Crowson 201740 | To develop a CV risk calculator for patients with RA | Model A (DAS28-ESR) Model B (HAQ) FRS PCE SCORE QRISK2 | 0.70 0.71 0.71 0.72 0.70 0.72 |
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Crowson 201734 | To externally validate risk algorithms recommended for use in patients with RA including the EULAR 1.5 multiplier, the ERS-RA, and QRISK2 | ERS-RA QRISK2 RRS FRS-ATP FRS-ATP + EULAR multiplier PCE PCE + EULAR multiplier | 0.69 0.72 0.72 0.75 0.75 0.72 0.72 | ERS-RA vs PCE: NRI = −0.8% (95% CI: −8.2, 7.1) ERS-RA vs FRS: NRI = 2.3% (95% CI: −8.3, 26.6) QRISK2 vs PCE: NRI = −2.4% (95% CI: −10.9, 6.5) QRISK2 vs FRS: NRI = 25% (95% CI: −9.4, 34.7) |
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Finckh 2012 37 | To determine whether including CV biomarkers offers added predictive ability over the established FRS for CV risk prediction in patients with RA | FRS + CRP FRS + RF FRS + anti-CCP FRS + ox-LDL FRS + NT-proBNP FRS + anti-apoA-I | 0.73 0.73 0.76 0.73 0.76 0.81 | FRS + anti–apoA-I: IDI = +175.4% (p = 0.01) | NT-proBNP was moderately predictive of subsequent MACE but did not substantially improve predictive ability of traditional risk factors. Only anti-apoA-I substantially enhanced the discrimination of the FRS (improvement in AUC +0.09). |
Ljung 2018 32 | To perform an external validation of the ERS-RA in a Swedish cohort of patients with RA | ERS-RA (Cohort 1) ERS-RA (Cohort 2 – including smoking data) ERS-RA (Cohort 2 – excluding smoking data) ERS-RA (Cohort 3) | 0.77 0.78 0.75 0.76 | The ERS-RA had good discriminatory capability but underestimated the 10-year CV risk in high-risk groups and in the absence of data on smoking. | |
Navarini 2018 31 | To evaluate the performance of FRS, SCORE, QRISK2, RRS, and CUORE, and adapt them to EULAR guidelines in patients with PsA | SCORE SCORE + EULAR multiplier CUORE CUORE + EULAR multiplier FRS FRS + EULAR multiplier QRISK2 QRISK2 + EULAR multiplier RRS RRS + EULAR multiplier | 0.7679 0.76790.864 0.8648 0.75750.7584 0.8660 0.8664 0.71830.7183 |
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Solomon 2015 39 | To develop and internally validate an expanded CV risk prediction score for RA | Base algorithm Developed algorithm (ERS-RA) | 0.7261 0.7609 | Base model vs ERS-RA (FRS): NRI = 40% (95% CI: 37, 44) Base model vs ERS-RA (PCE): NRI = 7% (95% CI: 6, 8) |
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Urowitz 2016 41 | To determine whether an adjustment to the FRS would more accurately reflect the higher prevalence of coronary artery disease among patients with SLE. | FRS 1.5 FRS 2 FRS 3 FRS 4 FRS | N/A | Sensitivity: 13.0, Specificity: 98.2 Sensitivity: 19.7, Specificity: 89.4 Sensitivity: 31.5, Specificity: 80.9 Sensitivity: 45.5, Specificity: 72.0 Sensitivity: 46.1, Specificity: 68.8 | Applying a multiplication factor of 2 to the FRS more accurately identified patients at moderate/high risk of coronary artery disease and more accurately predicts subsequent coronary artery disease. |
Anti-CCP: anticyclic citrullinated peptide; anti-apoA-I: anti-apolipoprotein A–I; AUC: area under the curve; CRP: C-reactive protein; CV: cardiovascular; ESR: erythrocyte sedimentation rate; DAS28-ESR: 28-joint count Disease Activity Score for RA using ESR; ERS-RA: Expanded Cardiovascular Risk Prediction Score for RA; EULAR: European League Against Rheumatism; FRS: Framingham Risk Score; FRS-ATP: FRS in Adult Treatment Panel; HAQ: Health Assessment Questionnaire; IDI: integrated discrimination improvement; MACE: major adverse CV event; N/A: not applicable; NRI: net reclassification improvement; NT-proBNP: N-terminal pro-brain natriuretic peptide; ox-LDL: oxidized low-density lipoprotein; PCE: American College of Cardiology/American Heart Association Pooled Cohort Equation; PsA: psoriatic arthritis; RA: rheumatoid arthritis; RF: rheumatoid factor; RRS: Reynolds Risk Score; SCORE: Systematic Coronary Risk Evaluation; SLE: systemic lupus erythematosus.