| Title: | External validation of the accuracy of cardiovascular risk prediction tools in psoriatic disease: a UK Biobank study |
| Journal: | Clinical Rheumatology |
| Published: | 20 Jan 2025 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/39833655/ |
| DOI: | https://doi.org/10.1007/s10067-025-07325-y |
Publication 14479
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Abstract
IntroductionRisk prediction is important for preventing and managing cardiovascular disease (CVD). CVD risk prediction tools designed for the general population may be inaccurate in people with inflammatory diseases.ObjectivesTo investigate the performance of four cardiovascular risk prediction tools (QRISK3, Framingham Risk Score, Reynolds Risk Score and SCORE) in psoriatic arthritis (PsA) and psoriasis. We also compare performance in participants with no inflammatory conditions and in people with rheumatoid arthritis (RA).MethodsThis research utilised the UK Biobank Resource. We identified participants with PsA, psoriasis and RA and calculated their cardiovascular risk using each risk tool. We assessed model calibration by comparing observed and predicted outcomes. Discrimination of 10-year risk prediction was assessed using time-dependent area under ROC curve (AUC), sensitivity, specificity, positive and negative predictive values.ResultsWe included 769 individuals with PsA, 8062 with psoriasis and 4772 with RA when assessing the QRISK3 tool. Predictions for individuals with psoriasis were roughly as accurate as those with no inflammatory conditions with time-dependent AUC of 0.74 (95%CI, 0.72, 0.76) and of 0.74 (95%CI, 0.72, 0.77) respectively. In contrast, individuals with PsA obtained the least accurate predictions with an AUC of 0.70 (95%CI, 0.64, 0.76). Individuals with RA also obtained less accurate predictions with AUC of 0.72 (0.69,0.74). For the Framingham risk score, AUCs varied between 0.61 (95%CI, 0.55, 0.68) for participants with PsA and 0.71 (95%CI, 0.68, 0.74) for individuals with no inflammatory condition.ConclusionsIn general, CVD risk prediction accuracy was similar for individuals with psoriasis or no inflammatory condition, but lower for individuals with PsA or RA.Key Points• Cardiovascular disease risk prediction tools are inaccurate in patients with inflammatory conditions such as rheumatoid arthritis.• CVD risk prediction was generally less accurate in people with psoriatic disease than the general population when using QRISK3, Framingham, Raynolds or SCORE tools.• QRISK3 tended to achieve the most accurate prediction but was poorly calibrated by overestimating risk.• QRISK3 generally overestimated risk; therefore, estimates may not need to be multiplied by 1.5 as recommended for inflammatory arthritis.</p>
17 Keywords
- Adult
- Aged
- Area Under Curve
- Arthritis, Psoriatic
- Arthritis, Rheumatoid
- Biological Specimen Banks
- Cardiovascular Diseases
- Female
- Heart Disease Risk Factors
- Humans
- Male
- Middle Aged
- Psoriasis
- ROC Curve
- Risk Assessment
- UK Biobank
- United Kingdom
3 Authors
- David M. Hughes
- Zenas Z. N. Yiu
- Sizheng Steven Zhao
1 Application
| Application ID | Title |
|---|---|
| 67547 | Cardiovascular risk prediction tools in Rheumatic Diseases |
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