Full Papers
The expanded cardiovascular risk prediction score as a cardiovascular mortality predictor in rheumatoid arthritis
I. Del Rincón1, J.F. Restrepo2, A. Escalante3
- Division of Rheumatoloy and Clinical Immunology, Department of Medicine, The University of Texas at San Antonio, TX, USA. delrincon@uthscsa.edu
- Division of Rheumatoloy and Clinical Immunology, Department of Medicine, The University of Texas at San Antonio, TX, USA.
- Division of Rheumatoloy and Clinical Immunology, Department of Medicine, The University of Texas at San Antonio, TX, USA.
CER19590
Full Papers
Received: 04/12/2025
Accepted : 16/03/2026
In Press: 18/06/2026
Abstract
OBJECTIVES:
We aimed to examine the performance of the expanded cardiovascular (CV) risk prediction score for rheumatoid arthritis (ERS-RA), the Framingham CV risk score and the carotid intima-media thickness (IMT) as predictors of CV mortality in patients with rheumatoid arthritis (RA).
METHODS:
We studied 1194 patients with RA who had an ultrasound measurement of the carotid IMT and who had clinical information to calculate the ERS-RA and the Framingham score. Deaths were confirmed by death certificate and attributed to a CV cause if the immediate or underlying cause of death was due to ICDM-9 codes 390-459. We compared areas under receiver operator characteristic curves (ROC AUC) and examined reclassification tables for the performance of each scale to correctly predict CV deaths.
RESULTS:
Patients were observed for 10,063 person-years, during which 271 patients died (22.6%), for an overall mortality rate of 2.7 deaths per 100 person-years (95% CI 2.4, 3.0). A CV cause of death was identified in 139 patients (11.6%), for a CV mortality rate of 1.4 per 100 person-years (1.2, 1.6). ROC AUCs were 0.72 (95% CI 0.68, 0.76) for the Framingham scale, 0.76 (95% CI 0.72, 0.81) for the carotid IMT and 0.84 (95% CI 0.81, 0.88) for the ERS-RA. Compared to the Framingham scale the ERS-RA correctly reclassified 6% of patients (p=0.02), while the carotid IMT correctly reclassified 5% (p=0.003).
CONCLUSIONS:
The ERS-RA was superior to the Framingham scale in the prediction of CV mortality in patients with RA.
