Lupus & antiphospholipid syndrome
Application of EULAR and European Society of Cardiology recommendations with regard to blood pressure and lipid management in antiphospholipid syndrome
Authors' conclusion
Multimodal risk assessment including disease-related and cardiometabolic features used for high-risk diseases such as DM can improve CVR management in APS.
Study context
- Population
- Patients with antiphospholipid syndrome (APS) without prior atherosclerotic cardiovascular events or diabetes mellitus (DM)
- Participants
- 111 patients
- Exposure
- Systematic Coronary Risk Evaluation (SCORE), modified-SCORE, DIME and APS-related classifiers vs actual cardiovascular risk (CVR) (European Society of Cardiology (ESC) guidelines) for blood pressure (BP) and lipid treatment eligibility
- Outcome
- BP and lipid treatment eligibility according to EULAR and ESC recommendations; classification ability (MCC) and agreement (kappa) vs actual CVR
Methodological detailsMatthews' correlation coefficient and Cohen's kappa, actual CVR per ESC guidelines as reference, including carotid/femoral plaque presence
- Matthews' correlation coefficient and Cohen's kappa
- Actual CVR per ESC guidelines as reference, including carotid/femoral plaque presence
Main finding
As reported in the abstract
SCORE underestimated high/very-high AR
>50% of cases
SCORE-guided BP/lipid treatment eligibility, high AR
4.2%/12.6%
SCORE-guided BP/lipid treatment eligibility, very-high AR
10.5%/16.8%
Low-moderate AR cases eligible for lipid-lowering therapy
5.3%
Observational data: associations, not effects.
Further findings
BP treatment: classification ability (Matthews' correlation coefficient (MCC)) and eligibility agreement (kappa)
- MCC with DIME, low-moderate risk
- 0.33
- MCC with DIME, very-high risk
- 0.32
- MCC with modified-SCORE+APSevents, high risk
- 0.25
- Kappa with DIME+APSevents or aPLprofile, high risk
- 0.51
- Kappa with DIME, very-high risk
- 0.31
Lipid treatment: classification ability (MCC) and eligibility agreement (kappa)
- MCC/kappa with SCORE (or modified-SCORE)+APSevents, low-moderate risk
- 0.43/0.41
- MCC/kappa with SCORE (or modified-SCORE)+APSevents, very-high risk
- 0.30/0.30
- MCC/kappa with DIME+aPLprofile, high risk
- 0.50/0.50
Original publication
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