Lupus & antiphospholipid syndrome
Personalizing cardiovascular risk prediction for patients with systemic lupus erythematosus
Authors' conclusion
The novel SLECRISK tool is more sensitive than the ACC/AHA for predicting moderate/high 10-year risk for MACE and may be particularly useful in predicting risk for young females with severe SLE.
Study context
- Population
- Patients in the Brigham and Women's Hospital SLE cohort
- Participants
- 1,243 patients90 major adverse cardiovascular event (MACEs)
- Comparison
- SLECRISK vs ACC/AHA Pooled Cohort Risk Equations, Framingham Risk Score (FRS) and Modified FRS (mFRS)
- Outcome
- Detection of moderate/high 10-year risk (≥7.5 %) of first MACE (MI, stroke or cardiac death)
- Follow-up
- 10 years
Methodological detailscohort, single-centre cohort, LASSO variable selection, Cox regression, bootstrap optimism-adjusted internal validation, 8946.5 person-years of follow-up; 46 myocardial infarction (MIs), 36 strokes, 19 cardiac deaths, MACE identified by ICD-9/10 codes, adjudicated by board-certified cardiologists
- Cohort
- Single-centre cohort
- LASSO variable selection
- Cox regression
- Bootstrap optimism-adjusted internal validation
- 8946.5 person-years of follow-up; 46 MIs, 36 strokes, 19 cardiac deaths
- MACE identified by ICD-9/10 codes, adjudicated by board-certified cardiologists
Performance
As reported in the abstract
Sensitivity for detecting moderate/high-risk (≥7.5 %) of MACE
| Test or model | Sensitivity |
|---|---|
| SLECRISK | 0.74 (95 %CI: 0.65, 0.83) |
| ACC/AHA | 0.38 (95 %CI: 0.28, 0.48) |
Sensitivity
SLECRISK0.74 (95 %CI: 0.65, 0.83)
ACC/AHA0.38 (95 %CI: 0.28, 0.48)
Further findings
Model performance, SLECRISK vs FRS and mFRS
- Model performance between SLECRISK, FRS, and mFRS were similar
Patients moderate/high-risk by SLECRISK but not ACC/AHA
- More likely to be young women with severe SLE and few other traditional cardiovascular disease (CVD) risk factors
Original publication
Personalizing cardiovascular risk prediction for patients with systemic lupus erythematosus. Semin Arthritis Rheum. Published 17 May 2024. doi:10.
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