title: Novel cardiovascular risk prediction models in patients with systemic lupus erythematosus.
abstract: Women with systemic lupus erythematosus (SLE) have increased risk for coronary heart disease (CHD) which is underestimated by the Framingham risk score (FRS). We hypothesized that new risk scores that include inflammation or vascular age in the risk calculation would better identify women with SLE at risk for CHD, particularly in those with subclinical coronary atherosclerosis. We calculated the FRS and Reynolds risk score (RRS) in 121 women with SLE and 65 age-matched female controls; coronary age-modified risk scores (camFRS, camRRS) were calculated using coronary age derived from the coronary artery calcium (CAC) score. Risk scores were compared in SLE and controls, and in SLE patients with and without CAC. Although CAC was present in 21 SLE patients (17%) and four controls (6%) (p = 0.033); the FRS, camFRS, RRS, and camRRS, did not differ significantly among SLE and controls (p > 0.05), but were all significantly higher in SLE patients with CAC compared with those without (p < 0.001 for all). The camFRS (8%, p = 0.016) but not camRRS (5%, p = 0.221) assigned significantly more SLE patients to a category of  ≥ 10% risk than conventional FRS (1%) and RRS (2%). The RRS was of limited use but coronary age may improve CHD risk prediction in SLE.
authors: Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, USA.
authors: V K
authors: VK
authors: Kawai
authors: J F
authors: JF
authors: Solus
authors: A
authors: A
authors: Oeser
authors: Y H
authors: YH
authors: Rho
authors: P
authors: P
authors: Raggi
authors: A
authors: A
authors: Bian
authors: T
authors: T
authors: Gebretsadik
authors: A
authors: A
authors: Shintani
authors: C M
authors: CM
authors: Stein
mesh_terms: D000328:Adult; D000367:Age Factors; D016022:Case-Control Studies; D003327:Coronary Disease / Q000209:etiology*; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008875:Middle Aged; D008955:Models, Cardiovascular; D018570:Risk Assessment