A Model to Predict Cardiovascular Events in Patients With Newly Diagnosed Wegener's Granulomatosis and Microscopic Polyangiitis
(2011) In Arthritis Care and Research 63(4). p.588-596- Abstract
- Objective. To create a prognostic tool to quantify the 5-year cardiovascular (CV) risk in patients with newly diagnosed Wegener's granulomatosis (WG) and microscopic polyangiitis (MPA) without premorbid CV disease. Methods. We reviewed CV outcomes during the long-term followup of patients in the first 4 European Vasculitis Study Group (EUVAS) trials of WG and MPA. CV events were defined as CV death, stroke, myocardial infarction, coronary artery bypass graft, or percutaneous coronary intervention. Logistic regression was performed to create a model to predict the absolute risk of a CV event. The model was tested using the Wegener's Granulomatosis Etanercept Trial (WGET) cohort. Results. Seventy-four (13.8%) of 535 patients with 5 years of... (More)
- Objective. To create a prognostic tool to quantify the 5-year cardiovascular (CV) risk in patients with newly diagnosed Wegener's granulomatosis (WG) and microscopic polyangiitis (MPA) without premorbid CV disease. Methods. We reviewed CV outcomes during the long-term followup of patients in the first 4 European Vasculitis Study Group (EUVAS) trials of WG and MPA. CV events were defined as CV death, stroke, myocardial infarction, coronary artery bypass graft, or percutaneous coronary intervention. Logistic regression was performed to create a model to predict the absolute risk of a CV event. The model was tested using the Wegener's Granulomatosis Etanercept Trial (WGET) cohort. Results. Seventy-four (13.8%) of 535 patients with 5 years of followup from the EUVAS trials had at least 1 CV event: 33 (11.7%) of 281 WG versus 41 (16.1%) of 254 MPA. The independent determinants of CV outcomes were older age (odds ratio [OR] 1.45, 95% confidence interval [95% CI] 1.11-1.90), diastolic hypertension (OR 1.97, 95% CI 0.98-3.95), and positive proteinase 3 (PR3) antineutrophil cytoplasmic antibody (ANCA) status (OR 0.39, 95% CI 0.20-0.74). The model was validated using the WGET cohort (area under the receiver operating characteristic curve of 0.80). Conclusion. Within 5 years of diagnosis of WG or MPA, 14% of patients will have a CV event. We have constructed and validated a tool to quantify the risk of a CV event based on age, diastolic hypertension, and PR3 ANCA status in patients without prior CV disease. In patients with vasculitis, PR3 ANCA is associated with a reduced CV risk compared to myeloperoxidase ANCA or negative ANCA status. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1966046
- author
- organization
- publishing date
- 2011
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Arthritis Care and Research
- volume
- 63
- issue
- 4
- pages
- 588 - 596
- publisher
- John Wiley & Sons Inc.
- external identifiers
-
- wos:000289422700015
- scopus:79957451940
- ISSN
- 2151-4658
- DOI
- 10.1002/acr.20433
- language
- English
- LU publication?
- yes
- id
- 285dc986-5d4b-4fa9-bafa-32c1f3449c9a (old id 1966046)
- date added to LUP
- 2016-04-01 09:58:10
- date last changed
- 2022-04-04 01:05:22
@article{285dc986-5d4b-4fa9-bafa-32c1f3449c9a, abstract = {{Objective. To create a prognostic tool to quantify the 5-year cardiovascular (CV) risk in patients with newly diagnosed Wegener's granulomatosis (WG) and microscopic polyangiitis (MPA) without premorbid CV disease. Methods. We reviewed CV outcomes during the long-term followup of patients in the first 4 European Vasculitis Study Group (EUVAS) trials of WG and MPA. CV events were defined as CV death, stroke, myocardial infarction, coronary artery bypass graft, or percutaneous coronary intervention. Logistic regression was performed to create a model to predict the absolute risk of a CV event. The model was tested using the Wegener's Granulomatosis Etanercept Trial (WGET) cohort. Results. Seventy-four (13.8%) of 535 patients with 5 years of followup from the EUVAS trials had at least 1 CV event: 33 (11.7%) of 281 WG versus 41 (16.1%) of 254 MPA. The independent determinants of CV outcomes were older age (odds ratio [OR] 1.45, 95% confidence interval [95% CI] 1.11-1.90), diastolic hypertension (OR 1.97, 95% CI 0.98-3.95), and positive proteinase 3 (PR3) antineutrophil cytoplasmic antibody (ANCA) status (OR 0.39, 95% CI 0.20-0.74). The model was validated using the WGET cohort (area under the receiver operating characteristic curve of 0.80). Conclusion. Within 5 years of diagnosis of WG or MPA, 14% of patients will have a CV event. We have constructed and validated a tool to quantify the risk of a CV event based on age, diastolic hypertension, and PR3 ANCA status in patients without prior CV disease. In patients with vasculitis, PR3 ANCA is associated with a reduced CV risk compared to myeloperoxidase ANCA or negative ANCA status.}}, author = {{Suppiah, Ravi and Judge, Andrew and Batra, Rajbir and Flossmann, Oliver and Harper, Lorraine and Höglund, Peter and Javaid, M. Kassim and Jayne, David and Mukhtyar, Chetan and Westman, Kerstin and Davis, John C., Jr. and Hoffman, Gary S. and McCune, W. Joseph and Merkel, Peter A. and St Clair, E. William and Seo, Philip and Spiera, Robert and Stone, John H. and Luqmani, Raashid}}, issn = {{2151-4658}}, language = {{eng}}, number = {{4}}, pages = {{588--596}}, publisher = {{John Wiley & Sons Inc.}}, series = {{Arthritis Care and Research}}, title = {{A Model to Predict Cardiovascular Events in Patients With Newly Diagnosed Wegener's Granulomatosis and Microscopic Polyangiitis}}, url = {{http://dx.doi.org/10.1002/acr.20433}}, doi = {{10.1002/acr.20433}}, volume = {{63}}, year = {{2011}}, }