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DAS28-γGT for the prediction of major cardiovascular events in rheumatoid arthritis: results from the ESPOIR cohort.
- Source :
-
Rheumatology . Mar2024, Vol. 63 Issue 3, p665-671. 7p. - Publication Year :
- 2024
-
Abstract
- Objective To validate the predictive value of the DAS28 γ-glutamyl transferase (DAS28-γGT) for the occurrence of major cardiovascular (CV) events (MACE) in the 'Etude et Suivi des Polyarthrites Indifférenciées Récentes' ESPOIR cohort. Methods Analysis of 13-year outcome from the ESPOIR cohort. RA patients with missing data for baseline γGT activity and those not followed-up to 1 year were excluded. Baseline DAS28-γGT was calculated using the following formula: 0.56*√TJ-28 + 0.28 * √SJ-28 + 2*ln(γGT) + 0.014 * GH. Our primary outcome was the merit of the DAS28-γGT in predicting the occurrence of MACE. Results Among the 696 patients [536 women, mean (s. d.) age of 49 (12) years], 34 MACE were recorded, with a mean time to event of 71 (44) months. Receiver operating characteristic curve analysis indicated that a DAS28-γGT >9.4 had the best sensitivity and specificity for the diagnosis of MACE during the observation period. DAS28-γGT >9.4 was predictive of the occurrence of MACE, with a hazard ratio (HR) of 3.11 (95% CI 1.41, 5.43). Multivariate Cox analyses confirmed higher DAS28-γGT (HR 2.44, 95% CI 1.05, 5.64) together with age (HR 1.04, 95% CI 1.01, 1.07) and diabetes mellitus (HR 4.12, 95% CI 1.55, 10.95) as independent predictors of MACE. There was a dose effect of the DAS28-γGT for MACE-risk prediction, which was in line with the application of the Framingham risk score. Conclusion The DAS28-γGT was identified in this large prospective cohort as an independent predictor of MACE in patients with RA. The DAS28-γGT is a simple and useful tool to evaluate CV risk in routine and warn the clinician about the CV risk burden in patients with RA. [ABSTRACT FROM AUTHOR]
- Subjects :
- *GAMMA-glutamyltransferase
*PREDICTIVE tests
*CONFIDENCE intervals
*MAJOR adverse cardiovascular events
*MULTIVARIATE analysis
*AGE distribution
*SEVERITY of illness index
*RISK assessment
*RHEUMATOID arthritis
*SYMPTOMS
*PREDICTION models
*RECEIVER operating characteristic curves
*SENSITIVITY & specificity (Statistics)
*LONGITUDINAL method
*PROPORTIONAL hazards models
*DISEASE risk factors
*DISEASE complications
*EVALUATION
Subjects
Details
- Language :
- English
- ISSN :
- 14620324
- Volume :
- 63
- Issue :
- 3
- Database :
- Academic Search Index
- Journal :
- Rheumatology
- Publication Type :
- Academic Journal
- Accession number :
- 175800508
- Full Text :
- https://doi.org/10.1093/rheumatology/kead251