title: SCORE and REGICOR function charts underestimate the cardiovascular risk in Spanish patients with rheumatoid arthritis.
abstract: BACKGROUND
  Our objective was to determine which one of the two function charts available in Spain to calculate cardiovascular (CV) risk, Systematic COronary Risk Evaluation (SCORE) or Framingham-REgistre GIroní del COR (REGICOR), should be used in patients with rheumatoid arthritis (RA).
  
  
  METHODS
  A series of RA patients seen over a one-year period without history of CV events were assessed. SCORE, REGICOR, modified (m)SCORE and mREGICOR according to the European League Against Rheumatism (EULAR) recommendations were applied. Carotid ultrasonography (US) was performed. Carotid intima-media thickness (cIMT) > 0.90 mm and/or carotid plaques were used as the gold standard test for severe subclinical atherosclerosis and high CV risk (US+). The area under the receiver operating curves (AUC) for the predicted risk for mSCORE and mREGICOR were calculated according to the presence of severe carotid US findings (US+).
  
  
  RESULTS
  We included 370 patients (80% women; mean age 58.9 ± 13.7 years); 36% had disease duration of 10 years or more; rheumatoid factor (RF) and/or anticyclic citrullinated peptide (anti-CCP) were positive in 68%; and 17% had extra-articular manifestations. The EULAR multiplier factor was used in 122 (33%) of the patients. The mSCORE was 2.16 ± 2.49% and the mREGICOR 4.36 ± 3.46%. Regarding US results, 196 (53%) patients were US+. The AUC mSCORE was 0.798 (CI 95%: 0.752 to 0.844) and AUC mREGICOR 0.741 (95% CI; 0.691 to 0.792). However, mSCORE and mREGICOR failed to identify 88% and 91% of US+ patients. More than 50% of patients with mSCORE ≥1% or mREGICOR >1% were US+.
  
  
  CONCLUSIONS
  Neither of these two function charts was useful in estimating CV risk in Spanish RA patients.
authors: Carmen
authors: C
authors: Gómez-Vaquero
authors: Alfonso
authors: A
authors: Corrales
authors: Andrea
authors: A
authors: Zacarías
authors: Javier
authors: J
authors: Rueda-Gotor
authors: Ricardo
authors: R
authors: Blanco
authors: Carlos
authors: C
authors: González-Juanatey
authors: Javier
authors: J
authors: Llorca
authors: Miguel A
authors: MA
authors: González-Gay
mesh_terms: D000368:Aged; D000465:Algorithms; D019540:Area Under Curve; D001172:Arthritis, Rheumatoid / Q000150:complications*; D002318:Cardiovascular Diseases / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013030:Spain
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