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Evaluation of cardiovascular risk in patients with rheumatoid arthritis: do cardiovascular biomarkers offer added predictive ability over established clinical risk scores?
Arthritis Care Res (Hoboken). 2012 Jun; 64(6):817-25.AC

Abstract

OBJECTIVE

To determine whether adding C-reactive protein, anti-cyclic citrullinated peptide antibodies, rheumatoid factor, N-terminal pro-brain natriuretic peptide (NT-proBNP), oxidized low-density lipoprotein (ox-LDL), or anti-apolipoprotein A-I (anti-Apo A-I) IgG to the Framingham 10-year cardiovascular (CV) risk score (FRS) could improve its CV prognostic accuracy in rheumatoid arthritis (RA).

METHODS

We performed an ancillary study derived from a prospective single-center cohort consisting of 118 RA patients without CV disease at baseline. The FRS and the various biomarkers were assessed at enrollment and their prognostic accuracy was determined using receiver operating characteristic (ROC) curve analysis. The incremental predictive ability of biomarkers was assessed using the integrated discrimination improvement (IDI) statistics.

RESULTS

During a median followup period of 9 years, the incidence of CV events was 16%. Both the FRS and 3 of the biomarkers (NT-proBNP, ox-LDL, and anti-Apo A-I) were significant predictors of subsequent CV events (area under the ROC curve [AUC] between 0.68 and 0.73). Anti-Apo A-I was the only biomarker to significantly improve the prognostic ability of the FRS, with AUCs increasing from 0.72 to 0.81 and the IDI improving by 175% (P < 0.001).

CONCLUSION

Among the biomarkers tested, only anti-Apo A-I significantly improved the FRS predictive ability.

Authors+Show Affiliations

Geneva University Hospitals and University of Geneva School of Medicine, 26 Avenue Beau-Sejour, Geneva, Switzerland. axel.finckh@hcuge.chNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22302385

Citation

Finckh, Axel, et al. "Evaluation of Cardiovascular Risk in Patients With Rheumatoid Arthritis: Do Cardiovascular Biomarkers Offer Added Predictive Ability Over Established Clinical Risk Scores?" Arthritis Care & Research, vol. 64, no. 6, 2012, pp. 817-25.
Finckh A, Courvoisier DS, Pagano S, et al. Evaluation of cardiovascular risk in patients with rheumatoid arthritis: do cardiovascular biomarkers offer added predictive ability over established clinical risk scores? Arthritis Care Res (Hoboken). 2012;64(6):817-25.
Finckh, A., Courvoisier, D. S., Pagano, S., Bas, S., Chevallier-Ruggeri, P., Hochstrasser, D., Roux-Lombard, P., Gabay, C., & Vuilleumier, N. (2012). Evaluation of cardiovascular risk in patients with rheumatoid arthritis: do cardiovascular biomarkers offer added predictive ability over established clinical risk scores? Arthritis Care & Research, 64(6), 817-25. https://doi.org/10.1002/acr.21631
Finckh A, et al. Evaluation of Cardiovascular Risk in Patients With Rheumatoid Arthritis: Do Cardiovascular Biomarkers Offer Added Predictive Ability Over Established Clinical Risk Scores. Arthritis Care Res (Hoboken). 2012;64(6):817-25. PubMed PMID: 22302385.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of cardiovascular risk in patients with rheumatoid arthritis: do cardiovascular biomarkers offer added predictive ability over established clinical risk scores? AU - Finckh,Axel, AU - Courvoisier,Delphine S, AU - Pagano,Sabrina, AU - Bas,Sylvette, AU - Chevallier-Ruggeri,Paola, AU - Hochstrasser,Denis, AU - Roux-Lombard,Pascale, AU - Gabay,Cem, AU - Vuilleumier,Nicolas, Y1 - 2012/02/02/ PY - 2012/2/4/entrez PY - 2012/2/4/pubmed PY - 2012/7/4/medline SP - 817 EP - 25 JF - Arthritis care & research JO - Arthritis Care Res (Hoboken) VL - 64 IS - 6 N2 - OBJECTIVE: To determine whether adding C-reactive protein, anti-cyclic citrullinated peptide antibodies, rheumatoid factor, N-terminal pro-brain natriuretic peptide (NT-proBNP), oxidized low-density lipoprotein (ox-LDL), or anti-apolipoprotein A-I (anti-Apo A-I) IgG to the Framingham 10-year cardiovascular (CV) risk score (FRS) could improve its CV prognostic accuracy in rheumatoid arthritis (RA). METHODS: We performed an ancillary study derived from a prospective single-center cohort consisting of 118 RA patients without CV disease at baseline. The FRS and the various biomarkers were assessed at enrollment and their prognostic accuracy was determined using receiver operating characteristic (ROC) curve analysis. The incremental predictive ability of biomarkers was assessed using the integrated discrimination improvement (IDI) statistics. RESULTS: During a median followup period of 9 years, the incidence of CV events was 16%. Both the FRS and 3 of the biomarkers (NT-proBNP, ox-LDL, and anti-Apo A-I) were significant predictors of subsequent CV events (area under the ROC curve [AUC] between 0.68 and 0.73). Anti-Apo A-I was the only biomarker to significantly improve the prognostic ability of the FRS, with AUCs increasing from 0.72 to 0.81 and the IDI improving by 175% (P < 0.001). CONCLUSION: Among the biomarkers tested, only anti-Apo A-I significantly improved the FRS predictive ability. SN - 2151-4658 UR - https://www.unboundmedicine.com/medline/citation/22302385/Evaluation_of_cardiovascular_risk_in_patients_with_rheumatoid_arthritis:_do_cardiovascular_biomarkers_offer_added_predictive_ability_over_established_clinical_risk_scores L2 - https://doi.org/10.1002/acr.21631 DB - PRIME DP - Unbound Medicine ER -