To evaluate the performance of the PREVENT cardiovascular disease (CVD) risk calculator in patients with rheumatoid arthritis (RA) compared to matched controls and to compare its performance to that of the Pooled Cohort Equations (PCE).
Approach:
Study Design: A retrospective, matched cohort study using National Veterans Health Administration (VHA) data from January 1, 2006, to December 31, 2019.
Cohort Selection: Patients with RA were matched with non-RA controls based on age, sex, and VHA enrollment year, requiring specific diagnostic codes and treatment history.
Risk Calculation: CVD risk was calculated using the PREVENT and PCE calculators, with baseline variables assessed over a 12-month lookback period.
Outcome Assessment: CVD outcomes included fatal and nonfatal acute myocardial infarction (AMI), stroke, and heart failure (HF).
Key Findings:
Existing CVD risk calculators underestimate risk in RA patients.
PREVENT incorporates factors like BMI and renal function, unlike previous calculators.
No data-driven strategy currently exists for CVD risk stratification in RA.
Interpretation:
The study highlights the need for effective CVD risk stratification tools specifically tailored for patients with rheumatoid arthritis, as current tools do not adequately address their unique risk profiles.
Limitations:
The study relies on retrospective data, which may introduce biases.
External validation of the PREVENT calculator in RA patients is limited.
Conclusion:
There is a critical need for validated CVD risk prediction tools specifically for patients with rheumatoid arthritis.
by Tate M. Johnson, Halie Frideres, Punyasha Roul, Joshua F. Baker, Brian C. Sauer, Grant W. Cannon, Isaac D. Smith, Gary A. Kunkel, Beth I. Wallace, Thomas R. Porter, Kaveh R. Bookani, Amarnath R. Annapureddy, Ted R. Mikuls, Bryant R. England
Investigators compared intra-articular microbial profiles and predicted metabolic pathways in patients with hip osteoarthritis and nonarthritic controls.
