Lupus & antiphospholipid syndrome
Machine learning improves 10-year prediction of atherosclerotic plaque progression and cardiovascular events in systemic lupus erythematosus
Authors' conclusion
Conventional and SLE-adapted tools underestimate CVD events and atherosclerosis progression risk in SLE. A machine learning-based model incorporating disease-specific and traditional cardiovascular risk factors into QRISK3 improves CVD risk stratification.
Study context
- Population
- Patients with systemic lupus erythematosus (SLE) without prior cardiovascular disease (CVD) eventspatients with 10-year ultrasonography follow-up (91% female, median age: 43.0 years)
- Participants
- 111 patientsEvents: 53 (47.7%) developed new plaques, and 8 (7.2%) had incident CVD events
- Predictors
- 11 CVD risk scores (7 conventional, 4 SLE-adapted); a machine learning-based gradient boosting model integrating QRISK3 with disease-related risk factors (disease duration, cumulative glucocorticoid dose, DORIS achievement, antiphospholipid antibodies, hydroxychloroquine) and additional traditional CVD risk factors (physical activity, waist circumference)
- Predicted outcome
- 10-year cardiovascular disease (CVD) events and atherosclerotic plaque progression
Methodological detailsmachine learning-based gradient boosting model developed and internally validated, logistic regression and time-to-event analyses
- Machine learning-based gradient boosting model developed and internally validated
- Logistic regression and time-to-event analyses
Model performance
As reported in the abstract
All 11 scores: sensitivity
0.00-0.44
All 11 scores: AUC
0.58-0.79
All 11 scores: BS
0.44-0.71
Further findings
Performance of the machine learning-based score
- Significantly better performance compared to all evaluated scores
CVD events and/or plaque progression, QRISK3 (multivariable analysis)
- QRISK3 HR
- 1.87
- p
- P = 0.027
- QRISK3 was the only tool independently associated with CVD events and/or plaque progression
Original publication
Machine learning improves 10-year prediction of atherosclerotic plaque progression and cardiovascular events in systemic lupus erythematosus. Rheumatology (Oxford). Published 29 October 2026. doi:10.
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