Performance of the Predicting Risk of Cardiovascular Disease Events Calculator in Rheumatoid Arthritis
Authors' conclusion
PREVENT underestimates CVD risk in RA, consistent with suboptimal performance of existing risk calculators.
Study context
- Population
- Patients with rheumatoid arthritis (RA) and matched controls, National Veterans Health Administration, Medicare and National Death Index data (2006–2020)>2 million person-years
- Participants
- 30,687 vs 231,752
- Exposure
- PREVENT calculator performance in RA vs matched controls; PREVENT vs Pooled Cohort Equations (PCE) for atherosclerotic CVD (ASCVD) in RA
- RAn = 30,687
- Controlsn = 231,752reference
- Outcome
- Calibration (SIR, observed/predicted events) and discrimination (sensitivity, Harrel's C-statistics) of PREVENT 10-year CVD risk
- Follow-up
- 10 years
Methodological detailsmatched up to 10 controls on age, sex and enrollment year, risk-prediction validation
- Matched up to 10 controls on age, sex and enrollment year
- Risk-prediction validation
Main finding
As reported in the abstract
PREVENT calibration in RA (SIR, observed/predicted)
- Overall cardiovascular disease (CVD) SIR in RA
- 1.83 (95% CI 1.79-1.88)
- ASCVD SIR in RA
- 2.25 (95% CI 2.19-2.32)
- Heart failure (HF) SIR in RA
- 1.41 (95% CI 1.36-1.46)
- Sensitivity for ASCVD in RA
- 61.9%
- Sensitivity for HF in RA
- 63.2%
Observational data: associations, not effects.
Further findings
PCE for ASCVD prediction in RA
- PCE ASCVD SIR
- 1.38 (95% CI 1.34-1.41)
- PCE ASCVD sensitivity
- 76.0%
- Net reclassification index (NRI) for PREVENT
- 5.3%
- Reclassified patients with ASCVD inappropriately reclassified as low or borderline risk
- 626 of 657
- PREVENT performance poorer than PCE for ASCVD
PREVENT including hemoglobin A1c in RA
- Overall CVD SIR
- 1.21 (95% CI 1.18-1.24)
- ASCVD SIR
- 1.45 (95% CI 1.41-1.50)
- HF SIR
- 0.79 (95% CI 0.76-0.82)
- ASCVD sensitivity
- 80.3%
- Performance significantly improved
Original publication
Performance of the Predicting Risk of Cardiovascular Disease Events Calculator in Rheumatoid Arthritis. Arthritis Rheumatol. Published 17 February 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →