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Utility of different cardiovascular disease prediction models in rheumatoid arthritis.
Purcarea, A; Sovaila, S; Udrea, G; Rezus, E; Gheorghe, A; Tiu, C; Stoica, V.
Afiliação
  • Purcarea A; Strasbourg Medical University, Civil Hospital Strasbourg, Internal Medicine Department, France ; "Carol Davila" University of Medicine and Pharmacy, "Cantacuzino" Hospital, Internal Medicine and Rheumatology Department, Bucharest, Romania.
  • Sovaila S; Civil Hospital Strasbourg, Internal Medicine Department, France.
  • Udrea G; "Carol Davila" University of Medicine and Pharmacy, "Cantacuzino" Hospital, Internal Medicine and Rheumatology Department, Bucharest, Romania.
  • Rezus E; "Grigore T. Popa" University of Medicine and Pharmacy, Rheumatology Department, Iasi, Romania.
  • Gheorghe A; Geomed-Klinik Hospital, Gerolzhofen, Internal Medicine Department, Germany.
  • Tiu C; "Carol Davila" University of Medicine and Pharmacy, University Emergency Hospital, Neurology Department, Bucharest, Romania.
  • Stoica V; "Carol Davila" University of Medicine and Pharmacy, "Cantacuzino" Hospital, Internal Medicine and Rheumatology Department, Bucharest, Romania.
J Med Life ; 7(4): 588-94, 2014.
Article em En | MEDLINE | ID: mdl-25713628
BACKGROUND: Rheumatoid arthritis comes with a 30% higher probability for cardiovascular disease than the general population. Current guidelines advocate for early and aggressive primary prevention and treatment of risk factors in high-risk populations but this excess risk is under-addressed in RA in real life. This is mainly due to difficulties met in the correct risk evaluation. This study aims to underline the differences in results of the main cardiovascular risk screening models in the real life rheumatoid arthritis population. METHODS: In a cross-sectional study, patients addressed to a tertiary care center in Romania for an biannual follow-up of rheumatoid arthritis and the ones who were considered free of any cardiovascular disease were assessed for subclinical atherosclerosis. Clinical, biological and carotidal ultrasound evaluations were performed. A number of cardiovascular disease prediction scores were performed and differences between tests were noted in regard to subclinical atherosclerosis as defined by the existence of carotid intima media thickness over 0,9 mm or carotid plaque. RESULTS: In a population of 29 Romanian rheumatoid arthritis patients free of cardiovascular disease, the performance of Framingham Risk Score, HeartSCORE, ARIC cardiovascular disease prediction score, Reynolds Risk Score, PROCAM risk score and Qrisk2 score were compared. All the scores under-diagnosed subclinical atherosclerosis. With an AUROC of 0,792, the SCORE model was the only one that could partially stratify patients in low, intermediate and high-risk categories. The use of the EULAR recommended modifier did not help to reclassify patients. CONCLUSION: The only score that showed a statistically significant prediction capacity for subclinical atherosclerosis in a Romanian rheumatoid arthritis population was SCORE. The additional calibration or the use of imaging techniques in CVD risk prediction for the intermediate risk category might be warranted.
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Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Artrite Reumatoide / Doenças Cardiovasculares / Modelos Biológicos Tipo de estudo: Etiology_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Male / Middle aged Idioma: En Revista: J Med Life Assunto da revista: MEDICINA Ano de publicação: 2014 Tipo de documento: Article País de afiliação: Romênia

Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Artrite Reumatoide / Doenças Cardiovasculares / Modelos Biológicos Tipo de estudo: Etiology_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Male / Middle aged Idioma: En Revista: J Med Life Assunto da revista: MEDICINA Ano de publicação: 2014 Tipo de documento: Article País de afiliação: Romênia