University Center of Excellence on Nephrologic, Rheumatologic and Rare Diseases (ERK-net, ERN-Reconnect and RITA-ERN Member) with Nephrology and Dialysis Unit and Center of Immuno-Rheumatology and Rare Diseases (CMID), San Giovanni Bosco Hub Hospital, Department of Clinical and Biological Sciences of the University of Turin, Torino, Italy.
University Center of Excellence on Nephrologic, Rheumatologic and Rare Diseases (ERK-net, ERN-Reconnect and RITA-ERN Member) with Nephrology and Dialysis Unit and Center of Immuno-Rheumatology and Rare Diseases (CMID), San Giovanni Bosco Hub Hospital, Department of Clinical and Biological Sciences of the University of Turin, Torino, Italy.
Int J Cardiol. 2022 Sep 15;363:185-189. doi: 10.1016/j.ijcard.2022.06.040. Epub 2022 Jun 14.
We aimed to apply and compare the QRISK3 and the adjusted Global AntiPhospholipid Syndrome (APS) Score (aGAPSS) in a cohort of systemic lupus erythematosus (SLE) patients, with and without a concomitant diagnosis of APS, in order to assess their augmented risk of developing cardiovascular diseases (CVDs).
Patients (25-85 yo) with a diagnosis of SLE and/or of Secondary APS (SAPS) were included. QRISK3 was calculated using the official online calculator; aGAPSS using the validated point-values based on aPL-profile and independent risk factors.
The cohort included 142 SLE patients: 34 SAPS (23.9%) and 108 SLE patients without APS (76.1%).When considering all the cohort, patients with cerebrovascular/coronary events showed higher values of aGAPSS (10.1 ± 6.2 vs. 5.8 ± 6.1; p = 0.007), but not of the QRISK3. Furthermore, a significant association was observed between the occurrence of these events and high-risk aGAPSS: p = 0.03 for aGAPSS≥8, p = 0.01 for aGAPSS ≥9, p = 0.008 for aGAPSS ≥10. aGAPSS strongly correlated with the occurrence of any thrombotic event, both at the uni- and multivariate analysis (p = 0.012 and p = 0.009). Male gender also resulted to positively correlate with the occurrence of any thrombotic event at both uni- and multivariate analysis (p = 0.017 and p = 0.03). Focusing on aPL-profile, regardless the diagnosis, we found a statistical significance only for aGAPSS (aPL+ =9.6 ± 6.3 vs. aPL- = 4.1 ± 5.1; p < 0.001).
Despite QRISK3 being more accurate than traditional risk score in predicting CVD risk in SLE patients, aGAPSS appears to be the most valuable tool for this purpose.
我们旨在应用并比较 QRISK3 和调整后的全球抗磷脂综合征（APS）评分（aGAPSS）在系统性红斑狼疮（SLE）患者中，包括同时诊断为 APS 和未诊断为 APS 的患者，以评估他们发生心血管疾病（CVDs）的风险增加情况。
纳入诊断为 SLE 和/或继发性 APS（SAPS）的患者。使用官方在线计算器计算 QRISK3；使用基于 aPL 谱和独立危险因素的验证点值计算 aGAPSS。
队列纳入了 142 名 SLE 患者：34 名 SAPS（23.9%）和 108 名无 APS 的 SLE 患者（76.1%）。当考虑整个队列时，发生脑血管/冠状动脉事件的患者 aGAPSS 值更高（10.1±6.2 比 5.8±6.1；p=0.007），但 QRISK3 则不然。此外，还观察到这些事件的发生与高风险 aGAPSS 之间存在显著关联：aGAPSS≥8 时 p=0.03，aGAPSS≥9 时 p=0.01，aGAPSS≥10 时 p=0.008。aGAPSS 在单变量和多变量分析中均与任何血栓事件的发生强烈相关（p=0.012 和 p=0.009）。在单变量和多变量分析中，男性也与任何血栓事件的发生呈正相关（p=0.017 和 p=0.03）。无论诊断如何，仅在 aPL 谱方面，我们发现 aGAPSS 具有统计学意义（aPL+ =9.6±6.3 比 aPL-=4.1±5.1；p<0.001）。
尽管 QRISK3 在预测 SLE 患者 CVD 风险方面比传统风险评分更准确，但 aGAPSS 似乎是最有价值的工具。
