Skip to main content

Advertisement

SpringerLink
Log in

Assessment of six cardiovascular risk calculators in Mexican mestizo patients with rheumatoid arthritis according to the EULAR 2015/2016 recommendations for cardiovascular risk management

  • Brief Report
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

Variability of the 10-year cardiovascular (CV) risk predicted by the Framingham Risk Score (FRS) using lipids, FRS using body mass index (BMI), Reynolds Risk Score (RRS), QRISK2, Extended Risk Score—Rheumatoid Arthritis (ERS-RA), and algorithm developed by the American College of Cardiology and the American Heart Association in 2013 (ACC/AHA 2013) according to the European League Against Rheumatism (EULAR) 2015/2016 update of its evidence-based recommendations for cardiovascular risk management in patients with rheumatoid arthritis (RA) has not been evaluated in Mexican mestizo patients. CV risk was predicted using six different risk calculators in 116 patients, aged 40–75, who fulfilled the ACR/EULAR 2010 classification criteria. Results were multiplied by 1.5 according to the EULAR 2015/2016 update. Global comparison of the risk predicted by all scales was done using the Friedman test, considering a P value of ≤0.05 as statistically significant. Individual comparison between the algorithms was made using the Wilcoxon signed-rank test, and a P value of ≤0.003 was considered statistically significant. All calculators showed to be different in the Friedman test (p ≤ 0.001). Median values of predicted 10-year CV risk were 11.02% (6.18–17.55) for FRS BMI; 8.47% (4.6–13.16) for FRS lipids; 5.55% (2.5–11.85) for QRISK2; 5% (3.1–8.65) for ERS-RA; 3.6% (1.5–9.3) for ACC/AHA 2013; and 1.5% (1.5–4.5) for RRS. ERS-RA showed no difference when compared against QRISK2 (p = 0.269). CV risk calculators showed variability among them and cannot be used indistinctly in RA-patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. You S, Cho CS, Lee I, Hood L, Hwang D, Kim WU (2012) A systems approach to rheumatoid arthritis. PLoS One 7:e51508

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Peters M, Symmons D, McCarey D, Dijkmans B, Nicola P, Kvien T et al (2010) EULAR evidence-based recommendations for cardiovascular risk management in patients with rheumatoid arthritis and other forms of inflammatory arthritis. Ann Rheum Dis 69:325–331

    Article  CAS  PubMed  Google Scholar 

  3. Pieringer H, Pichler M (2011) Cardiovascular morbidity and mortality in patients with rheumatoid arthritis: vascular alterations and possible clinical implications. QJM 104:13–26

    Article  CAS  PubMed  Google Scholar 

  4. Sarmiento-Monroy JC, Amaya-Amaya J, Espinosa-Serna JS, Herrera-Díaz C, Anaya J-M, Rojas-Villarraga A (2012) Cardiovascular disease in rheumatoid arthritis: a systematic literature review in Latin America. Arthritis 2012:371909

    Article  PubMed  PubMed Central  Google Scholar 

  5. Barber CE, Smith A, Esdaile JM, Barnabe C, Martin LO, Faris P et al (2015) Best practices for cardiovascular disease prevention in rheumatoid arthritis: a systematic review of guideline recommendations and quality indicators. Arthritis Care Res (Hoboken) 67:169–179

    Article  Google Scholar 

  6. Choy E, Ganeshalingam K, Semb AG, Szekanecz Z, Nurmohamed M (2014) Cardiovascular risk in rheumatoid arthritis: recent advances in the understanding of the pivotal role of inflammation, risk predictors and the impact of treatment. Rheumatology (Oxford) 53:2143–2154

    Article  Google Scholar 

  7. Solomon DH, Greenberg J, Curtis JR, Liu M, Farkouh M, Tsao P et al (2015) Derivation and internal validation of an expanded cardiovascular risk prediction score for rheumatoid arthritis: a consortium of rheumatology researchers of North America registry study. Arthritis Rheumatol 67:1995–2003

    Article  CAS  PubMed  Google Scholar 

  8. Agca R, Heslinga S, Rollefstad S, Heslinga M, McInnes I, Peters M, et al. (2016) EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update. Ann Rheum Dis [journal on the internet]. 2013 Oct 3[date cited 2013 Dec 7]. doi:10.1136/annrheumdis-2016-209775

  9. D'Agostino RB Sr, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM et al (2008) General cardiovascular risk profile for use in primary care: the Framingham heart study. Circulation 117:743–753

    Article  PubMed  Google Scholar 

  10. Ridker PM, Buring JE, Rifai N, Cook NR (2007) Development and validation of improved algorithms for the assessment of global cardiovascular risk in women: the Reynolds risk score. JAMA 297:611–619

    Article  CAS  PubMed  Google Scholar 

  11. Hippisley-Cox J, Coupland C, Vinogradova Y, Robson J, Minhas R, Sheikh A et al (2008) Predicting cardiovascular risk in England and Wales: prospective derivation and validation of QRISK2. BMJ 336:1475–1482

    Article  PubMed  PubMed Central  Google Scholar 

  12. Arts E, Popa C, Den Broeder A, Semb A, Toms T, Kitas G et al (2014) Performance of four current risk algorithms in predicting cardiovascular events in patients with early rheumatoid arthritis. Ann Rheum Dis 74:668–674

    Article  PubMed  Google Scholar 

  13. Crowson CS, Matteson EL, Roger VL, Therneau TM, Gabriel SE (2012) Usefulness of risk scores to estimate the risk of cardiovascular disease in patients with rheumatoid arthritis. Am J Cardiol 110:420–424

    Article  PubMed  PubMed Central  Google Scholar 

  14. Damen JA, Hooft L, Schuit E, Debray TP, Collins GS, Tzoulaki I et al (2016) Prediction models for cardiovascular disease risk in the general population: systematic review. BMJ 353:i2416

    Article  PubMed  PubMed Central  Google Scholar 

  15. Goff DC Jr, Lloyd-Jones DM, Bennett G, Coady S, D'Agostino RB, Gibbons R et al (2014) 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. Circulation 129:S49–S73

    Article  PubMed  Google Scholar 

  16. Guardado-Estrada M, Juarez-Torres E, Medina-Martinez I, Wegier A, Macías A, Gomez G et al (2009) A great diversity of Amerindian mitochondrial DNA ancestry is present in the Mexican mestizo population. J Hum Genet 54:695–705

    Article  PubMed  Google Scholar 

  17. Turesson C, Jacobsson L, Bergström U (1999) Extra-articular rheumatoid arthritis: prevalence and mortality. Rheumatology (Oxford) 38:668–674

    Article  CAS  Google Scholar 

  18. González-Gay MA, González-Juanatey C (2014) Inflammation and lipid profile in rheumatoid arthritis: bridging an apparent paradox. Ann Rheum Dis 73:1281–1283

    Article  PubMed  Google Scholar 

  19. Alcocer LA, Lozada O, Fanghänel G, Sánchez-Reyes L, Campos-Franco E (2011) Estratificación del riesgo cardiovascular global. Comparación de los métodos Framingham y SCORE en población mexicana del estudio PRIT. Cir Cir 79:168–174

    PubMed  Google Scholar 

  20. Mosca L, Barrett-Connor E, Kass Wenger N (2011) Sex/gender differences in cardiovascular disease prevention: what a difference a decade makes. Circulation 124:2145–2154

    Article  PubMed  PubMed Central  Google Scholar 

  21. Catapano AL, Reiner Z, De Backer G (2011) European Atherosclerosis Society (EAS). ESC/EAS guidelines for the management of dyslipidaemias the task force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Atherosclerosis 217:3–46

    Article  CAS  PubMed  Google Scholar 

  22. Dessein PH, Corrales A, Lopez-Mejias R, Solomon A, Woodiwiss AJ, Llorca J et al (2016) The Framingham score and the systematic coronary risk evaluation at low cutoff values are useful surrogate markers of high-risk subclinical atherosclerosis in patients with rheumatoid arthritis. J Rheumatol 43:486–494

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Internal Medicine Department, University Hospital Dr. Jose Eleuterio Gonzalez UANL, Francisco I. Madero y Gonzalitos S/N, 64460, Monterrey, Nuevo Leon, Mexico

    Dionicio A. Galarza-Delgado, Jesus A. Cardenas-de la Garza, Griselda Serna-Peña, Rosa I. Arvizu-Rivera & Martin Wah-Suarez

  2. Internal Medicine Department, Cardiology Division, University Hospital Dr. Jose Eleuterio Gonzalez UANL, Francisco I. Madero y Gonzalitos S/N, 64460, Monterrey, Nuevo Leon, Mexico

    Jose R. Azpiri-Lopez, Raymundo Vera-Pineda & Adrian Martinez-Moreno

  3. Internal Medicine Department, Rheumatology Division, University Hospital Dr. Jose Eleuterio Gonzalez UANL, Francisco I. Madero y Gonzalitos S/N, 64460, Monterrey, Nuevo Leon, Mexico

    Iris J. Colunga-Pedraza & Mario A. Garza Elizondo

Authors
  1. Dionicio A. Galarza-Delgado
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jose R. Azpiri-Lopez
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Iris J. Colunga-Pedraza
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jesus A. Cardenas-de la Garza
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Raymundo Vera-Pineda
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Griselda Serna-Peña
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Rosa I. Arvizu-Rivera
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Adrian Martinez-Moreno
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Martin Wah-Suarez
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Mario A. Garza Elizondo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Dionicio A. Galarza-Delgado.

Ethics declarations

The research protocol was approved by our local ethics committee. Consent was not withdrawn by any patient.

ᅟ

Disclosures

None.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Galarza-Delgado, D.A., Azpiri-Lopez, J.R., Colunga-Pedraza, I.J. et al. Assessment of six cardiovascular risk calculators in Mexican mestizo patients with rheumatoid arthritis according to the EULAR 2015/2016 recommendations for cardiovascular risk management. Clin Rheumatol 36, 1387–1393 (2017). https://doi.org/10.1007/s10067-017-3551-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-017-3551-7

Keywords

Search

Navigation