Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
A New 30-Year Cardiovascular Risk Prediction Score Does Not Differ in Women with Systemic Lupus Erythematosus and Control Subjects.
Kawai1, Vivian K., Solus1, Joseph F., Oeser1, Annette, Rho1, Young Hee, Raggi2, Paolo, Bian3, Aihua, Gebretsadik3, Tebeb
Lupus primarily affects young women and is associated with accelerated atherosclerosis and increased risk of coronary heart disease (CHD). Conventional 10-year CHD risk prediction scores, such as the Framingham risk score, perform poorly and are not different in patients with SLE and controls. Long-term cardiovascular risk scores that take into account the cumulative effect of risk factors present in early adulthood have been developed specifically to assess CHD risk in younger populations and could be more suitable for risk prediction in SLE. We examined the hypothesis that a new long-term cardiovascular risk prediction model, the Framingham Heart Study 30-year risk score, is higher in women with lupus compared to controls. Age is the strongest risk factor for coronary atherosclerosis. Thus, we also examined the hypothesis that the 30-year risk score predicts the presence of subclinical coronary atherosclerosis better than age in women with SLE.
We performed a cross-sectional, case-control study of 121 women with lupus and 65 control subjects matched for age, sex and race. Subjects with diabetes or CHD were excluded. Demographic, clinical and laboratory data and coronary artery calcium scores (CACS) were recorded and 30-year risk scores were calculated. The 30-year risk score estimates the probability of having a cardiovascular event (%) in the next 30 years. The Wilcoxon rank sum test was used to compare the 30-year risk score in lupus and controls, and in lupus patients with and without CAC. We used the area under the receiver operating characteristic curve (AUC) to quantify the ability of the 30-year risk model to discriminate subclinical atherosclerosis (presence of CAC) in SLE and we compared it with AUC for age.
The 30-year risk score did not differ significantly in women with lupus and controls (5.0 [2.79.5]% vs. 6.3 [2.211.5]%, p=0.75, Fig 1) despite the more frequent presence of CAC in lupus (21/121, 17%) compared to controls (4/65, 6%) (p=0.033). SLE patients with CAC had higher 30-year risk scores than those without (14.5 [6.517.9]% vs. 4.5 [2.47.6]%, p<0.001); however, the ability of the 30-year risk model to identify patients with CAC did not differ significantly from that of age alone (AUC 0.746, 95% CI (0.616, 0.875) vs. AUC=0.773, 95% CI (0.660, 0.886), p=0.41 (Fig. 2).
The 30-year CHD risk prediction score is not different in patients with SLE and controls and its ability to predict subclinical atherosclerosis in SLE is similar to that of age alone.
To cite this abstract, please use the following information:
Kawai, Vivian K., Solus, Joseph F., Oeser, Annette, Rho, Young Hee, Raggi, Paolo, Bian, Aihua, et al; A New 30-Year Cardiovascular Risk Prediction Score Does Not Differ in Women with Systemic Lupus Erythematosus and Control Subjects. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :588