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QRISK3 与颈动脉斑块的相关性高于系统性红斑狼疮患者的评分。

QRISK3 relation to carotid plaque is higer than that of score in patients with systemic lupus erythematosus.

机构信息

Division of Rheumatology, Hospital Doctor Negrín, Las Palmas de Gran Canaria.

Epidemiology and Public Health Group, IDIVAL.

出版信息

Rheumatology (Oxford). 2022 Apr 11;61(4):1408-1416. doi: 10.1093/rheumatology/keab531.

DOI:10.1093/rheumatology/keab531

PMID:34240117

Abstract

INTRODUCTION

SLE has been described as an independent risk factor for the development of cardiovascular (CV) disease. Recently, the QRESEARCH risk estimator version 3 (QRISK3) calculator has been launched for CV risk assessment in the general population. QRISK3 now includes the presence of SLE as one of its variables for calculating CV risk. Our objective was to compare the predictive capacity between QRISK3 and the Systematic Coronary Risk Evaluation (SCORE) for the presence of subclinical carotid atherosclerosis in patients with SLE.

METHODS

Two hundred and ninety-six patients with SLE were recruited. The presence of subclinical atherosclerosis was evaluated by carotid ultrasound to identify carotid plaque and the thickness of the carotid intima-media (cIMT). QRISK3 and SCORE were calculated. The relationship of QRISK3 and SCORE with each other and with the presence of subclinical carotid atherosclerosis (both carotid plaque and cIMT) was studied.

RESULTS

There was no correlation between SCORE and QRISK3 in patients with SLE (Spearman's rho = -0.008, P = 0.90). Although QRISK3 showed a statistically significant correlation with cIMT (Spearman's rho = 0.420, P = 0.000), this relationship was not found between SCORE and cIMT (Spearman's rho = -0.005, P = 0.93). The discrimination capacity of QRISK3 for the presence of carotid plaque was statistically significant and superior to that of SCORE (AUC 0.765 [95% CI: 0.711, 0.820] vs 0.561 [95% CI: 0.494, 0.629], P = 0.000).

CONCLUSION

QRISK3 discrimination for subclinical atherosclerosis is higher than that of SCORE. QRISK3, and not SCORE, should be used for the calculation of CV risk in patients with SLE.

摘要

简介

系统性红斑狼疮（SLE）已被描述为心血管疾病（CV）发展的独立危险因素。最近，QRESEARCH 风险评估器版本 3（QRISK3）计算器已推出，用于普通人群的 CV 风险评估。QRISK3 现在将 SLE 的存在作为其计算 CV 风险的变量之一。我们的目的是比较 QRISK3 和系统性冠状动脉风险评估（SCORE）在评估 SLE 患者亚临床颈动脉粥样硬化中的预测能力。

方法

共招募了 296 例 SLE 患者。通过颈动脉超声评估亚临床动脉粥样硬化的存在，以确定颈动脉斑块和颈动脉内膜-中层厚度（cIMT）。计算 QRISK3 和 SCORE。研究 QRISK3 和 SCORE 之间以及与亚临床颈动脉粥样硬化（颈动脉斑块和 cIMT）之间的关系。

结果

SLE 患者中 SCORE 与 QRISK3 之间无相关性（Spearman's rho = -0.008，P = 0.90）。尽管 QRISK3 与 cIMT 呈统计学显著相关（Spearman's rho = 0.420，P = 0.000），但 SCORE 与 cIMT 之间没有这种关系（Spearman's rho = -0.005，P = 0.93）。QRISK3 对颈动脉斑块存在的判别能力具有统计学意义，且优于 SCORE（AUC 0.765 [95%CI：0.711，0.820] 与 0.561 [95%CI：0.494，0.629]，P = 0.000）。