Prediction of cardiovascular events in rheumatoid arthritis using risk age calculations: evaluation of concordance across risk age models

Wibetoe, Grunde; Sexton, Joseph; Ikdahl, Eirik; Rollefstad, Silvia; Kitas, George D.; van Riel, Piet; Gabriel, Sherine; Kvien, Tore K.; Douglas, Karen; Sandoo, Aamer; Arts, Elke E.; Wållberg-Jonsson, Solveig; Dahlqvist, Solbritt Rantapää; Karpouzas, George; Dessein, Patrick H.; Tsang, Linda; El-Gabalawy, Hani; Hitchon, Carol A.; Pascual-Ramos, Virginia; Contreas-Yañes, Irazu; Sfikakis, Petros P.; González-Gay, Miguel A.; Colunga-Pedraz, Iris J.; Galarza-Delgado, Dionicio A.; Azpiri-Lopez, Jose Ramon; Crowson, Cynthia S.; Semb, Anne Grete

doi:10.1186/s13075-020-02178-z

Table 3 Discriminatory ability according to stratification by RA disease characteristics

From: Prediction of cardiovascular events in rheumatoid arthritis using risk age calculations: evaluation of concordance across risk age models

		Sex			RF		ACPA		ACPA/RF		bDMARDs
	All	Male	Female		Positive	Negative	Positive	Negative	Positive	Negative	Use	No use
Cardiovascular risk age	0.68 (0.03)	0.7 (0.05)	0.63 (0.05)		0.68 (0.04)	0.68 (0.08)	0.72 (0.04)	0.61 (0.06)	0.71 (0.04)	0.65 (0.1)	0.78 (0.14)	0.67 (0.03)
Vascular age [H-risk]	0.71 (0.03)	0.72 (0.05)	0.67 (0.04)		0.7 (0.04)	0.77 (0.07)	0.74 (0.04)	0.67 (0.06)	0.74 (0.04)	0.75 (0.08)	0.78 (0.14)	0.71 (0.03)
Vascular age [L-risk]	0.71 (0.03)	0.72 (0.05)	0.67 (0.04)		0.7 (0.04)	0.76 (0.07)	0.74 (0.04)	0.67 (0.06)	0.73 (0.04)	0.74 (0.08)	0.8(0.14)	0.71 (0.03)
Vascular age [HDLc H-risk	0.71 (0.03)	0.71 (0.05)	0.68 (0.04)		0.7 (0.03)	0.78 (0.07)	0.73 (0.04)	0.69 (0.06)	0.72 (0.04)	0.77 (0.08)	0.78 (0.14)	0.71 (0.03)
Vascular age [HDLc L-risk]	0.72 (0.03)	0.72 (0.05)	0.68 (0.04)		0.7 (0.03)	0.76 (0.07)	0.74 (0.04)	0.69 (0.06)	0.73 (0.04)	0.75 (0.08)	0.79 (0.14)	0.71 (0.03)
	Glucocorticoids		DAS28		RA disease duration			Methotrexate			sDMARDs
	Use	No use	< 3.2	≥ 3.2	≤ 1 year	> 1 year		Use	No use		Use	No use
Cardiovascular risk age	0.57 (0.08)	0.71 (0.04)	0.6 (0.09)	0.69 (0.04)	0.69 (0.03)	0.6 (0.08)		0.67 (0.09)	0.68 (0.03)		0.62 (0.08)	0.69 (0.03)
Vascular age [H-risk]	0.61 (0.08)	0.74 (0.03)	0.67 (0.09)	0.72 (0.03)	0.73 (0.03)	0.63 (0.08)		0.68 (0.09)	0.72 (0.03)		0.64 (0.08)	0.73 (0.03)
Vascular age [L-risk]	0.59 (0.08)	0.74 (0.03)	0.67 (0.09)	0.71 (0.03)	0.73 (0.03)	0.63 (0.08)		0.7 (0.09)	0.71 (0.03)		0.65 (0.08)	0.72 (0.03)
Vascular age [HDLc H-risk	0.6 (0.08)	0.74 (0.03)	0.66 (0.09)	0.72 (0.03)	0.73 (0.03)	0.63 (0.08)		0.69 (0.09)	0.72 (0.03)		0.65 (0.08)	0.72 (0.03)
Vascular age [HDLc Lrisk]	0.62 (0.08)	0.74 (0.03)	0.67 (0.09)	0.72 (0.03)	0.73 (0.03)	0.64 (0.08)		0.71 (0.09)	0.72 (0.03)		0.66 (0.08)	0.72 (0.03)

Concordance index (standard error) presenting the discriminative ability in ranking individuals who do or do not experience cardiovascular events correctly as high and low risk. Values are presented for various risk age models, including vascular age estimations derived from application of different Systematic Coronary Risk Evaluation algorithms with or without use of high-density lipoprotein-cholesterol (HDLc) for high- and low-risk countries (H-risk and L-risk). Individuals were also stratified according to sex, rheumatoid factor (RF), and anti-cyclic citrullinated peptide antibody (ACPA) positivity, use of biologic or synthetic disease modifying antirheumatic drugs (bDMARDs and sDMARDs), disease activity score using 28-joint count (DAS28), and duration of rheumatoid arthritis (RA)
Significance and innovations
• Risk age estimations have been advocated in current guidelines for CVD prevention
• The two proposed risk age models have not been validated
• Our results indicate comparable performance of risk age models in rheumatoid arthritis patients

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ISSN: 1478-6362

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