Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun 19.
doi: 10.1097/RHU.0000000000002250. Online ahead of print.

Comparison of Cardiovascular Risk Scores Performances in a Contemporary Mixed-Ancestry Systemic Lupus Erythematosus Population

Débora Cordeiro do Rosário  1 , Luciana Parente Costa Seguro, Francisco Fellipe Claudino Formiga, Isabela Maria Bertoglio, Juliana Miranda De Lucena Valim, Dilson Marreiros Nunes Filho, Michelle Remião Ugolini Lopes, Eloisa Bonfa
Affiliations

Comparison of Cardiovascular Risk Scores Performances in a Contemporary Mixed-Ancestry Systemic Lupus Erythematosus Population

Débora Cordeiro do Rosário et al. J Clin Rheumatol. .

Abstract

Objective: Cardiovascular disease (CVD) remains the leading cause of mortality in systemic lupus erythematosus (SLE). This study compared the performance of SLE Cardiovascular Risk Equation (SLECRE), Framingham Risk Score (FRS), modified Framingham Risk Score (mFRS), and QRISK3 in estimating CVD risk in a recent and mixed ancestry population of SLE patients (2009-2021). Additionally, a simpler model, the Easy Atherosclerosis Risk Assessment for SLE (EASLE), was proposed.

Methods: A historical analysis of 550 SLE patients with 10-year follow-up in a tertiary hospital was conducted. Traditional and SLE-specific risk factors for CVD were obtained through electronic medical records (2009-2011), and the incidence of cardiovascular (CV) events over the subsequent 10 years (2019-2021) was evaluated. Variables associated with CV events were included in the multiple logistic regression to develop the EASLE. The performances of SLECRE, FRS, mFRS, QRISK3, and EASLE were assessed and compared. Multiple logistic regression was used to develop the EASLE.

Results: Among 550 patients, 34 CVD events were observed (6.2%). Sensitivity and specificity were, respectively, 17.6% and 94.4% in FRS, 58.8% and 84.9% in mFRS, 38.2% and 86.4% in QRISK3, and 91.2% and 22.3% in SLECRE. The areas under the curve were 0.708 for both FRS and mFRS, 0.703 for QRISK3, and 0.553 for SLECRE. The mFRS had the highest balanced accuracy (71.9%). EASLE, with only 3 variables (age, smoking status, and antihypertensive treatment) had 55.9% sensitivity, 86.8% specificity, 71.3% balanced accuracy, and an area under the curve of 0.752.

Conclusions: The mFRS and EASLE exhibited comparable performances and highest balanced accuracies in a recent mixed-ancestry SLE population. EASLE, a simplified tool, offers a promising tool for CVD risk assessment in SLE patients, especially in resource-limited settings.

Keywords: Framingham Risk Score; assessment; atherosclerosis; cardiovascular risk; systemic lupus erythematosus (SLE).

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Similar articles

See all similar articles

References

    1. World Health Organization. Global health estimates 2019: deaths by cause, age, sex, by country and by region, 2000–2019. 2020. Available at: https://www.who.int/healthinfo/global_burden_disease/estimates/en/index1.... Accessed 26 November, 2023.
    1. England BR, Thiele GM, Anderson DR, et al. Increased cardiovascular risk in rheumatoid arthritis: mechanisms and implications. BMJ. 2018;361:k1036.
    1. Bruce IN, Urowitz MB, Gladman DD, et al. Risk factors for coronary heart disease in women with systemic lupus erythematosus: the Toronto Risk Factor Study. Arthritis Rheum. 2003;48:3159–3167.
    1. Manzi S, Meilahn EN, Rairie JE, et al. Age-specific incidence rates of myocardial infarction and angina in women with systemic lupus erythematosus: comparison with the Framingham Study. Am J Epidemiol. 1997;145:408–415.
    1. Esdaile JM, Abrahamowicz M, Grodzicky T, et al. Traditional Framingham risk factors fail to fully account for accelerated atherosclerosis in systemic lupus erythematosus. Arthritis Rheum. 2001;44:2331–2337.

LinkOut - more resources