Wagan Abrar Ahmed, Mahmud Tafazzul E Haque, Rasheed Aflak, Zafar Zafar Ali, Rehman Ata Ur, Ali Amjad
Dr. Abrar Ahmed Wagan, FCPS (Medicine). Department of Rheumatology, Sheikh Zayed Federal Post Graduate Institute, Lahore, Pakistan.
Dr. Tafazzul E Haque Mahmud, MRCP, FRCP. Department of Rheumatology, Sheikh Zayed Federal Post Graduate Institute, Lahore, Pakistan.
Pak J Med Sci. 2016 May-Jun;32(3):534-8. doi: 10.12669/pjms.323.9779.
To determine the 10-year Cardiovascular risk score with QRISK-2 and Framingham risk calculators in Rheumatoid Arthritis and Non Rheumatoid Arthritis subjects and asses the usefulness of QRISK-2 and Framingham calculators in both groups.
During the study 106 RA and 106 Non RA patients age and sex matched participants were enrolled from outpatient department. Demographic data and questions regarding other study parameters were noted. After 14 hours of fasting 5 ml of venous blood was drawn for Cholesterol and HDL levels, laboratory tests were performed on COBAS c III (ROCHE). QRISK-2 and Framingham risk calculators were used to get individual 10-year CVD risk score.
In this study the mean age of RA group was (45.1±9.5) for Non RA group (43.7±8.2), with female gender as common. The mean predicted 10-year score with QRISK-2 calculator in RA group (14.2±17.1%) and Non RA group was (13.2±19.0%) with (p-value 0.122). The 10-year score with Framingham risk score in RA group was (12.9±10.4%) and Non RA group was (8.9±8.7%) with (p-value 0.001). In RA group QRISK-2 (24.5%) and FRS (31.1%) cases with predicted score were in higher risk category. The maximum agreement scores between both calculators was observed in both groups (Kappa = 0.618 RA Group; Kappa = 0.671 Non RA Group).
QRISK-2 calculator is more appropriate as it takes RA, ethnicity, CKD, and Atrial fibrillation as factors in risk assessment score.
使用QRISK-2和弗雷明汉风险评估工具确定类风湿关节炎患者和非类风湿关节炎患者的10年心血管疾病风险评分，并评估QRISK-2和弗雷明汉评估工具在两组中的实用性。
在研究期间，从门诊部招募了106例年龄和性别相匹配的类风湿关节炎患者和106例非类风湿关节炎患者。记录人口统计学数据以及有关其他研究参数的问题。禁食14小时后，采集5毫升静脉血用于检测胆固醇和高密度脂蛋白水平，在COBAS c III（罗氏公司）上进行实验室检测。使用QRISK-2和弗雷明汉风险评估工具获得个体的10年心血管疾病风险评分。
在本研究中，类风湿关节炎组的平均年龄为（45.1±9.5）岁，非类风湿关节炎组为（43.7±8.2）岁，女性居多。使用QRISK-2评估工具得出的类风湿关节炎组10年预测评分均值为（14.2±17.1%），非类风湿关节炎组为（13.2±19.0%），p值为0.122。使用弗雷明汉风险评分得出的类风湿关节炎组10年评分均值为（12.9±10.4%），非类风湿关节炎组为（8.9±8.7%），p值为0.001。在类风湿关节炎组中，QRISK-2（24.5%）和弗雷明汉风险评分（FRS，31.1%）预测评分处于高风险类别的病例。两组中两种评估工具之间的最大一致性评分（类风湿关节炎组Kappa = 0.618；非类风湿关节炎组Kappa = 0.671）。
QRISK-2评估工具更合适，因为它将类风湿关节炎、种族、慢性肾脏病和心房颤动作为风险评估评分的因素。
