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Hi, my name is Ekal Sud reporting for RheumNow.
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When it comes to the quality of care, it's important to understand how well the available tools recommended by national societies apply to our patients.
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Take cardiovascular risk for example. The American College of Cardiology and the American Heart Association recommend the use of the PREVENT risk calculator to estimate cardiovascular risk.
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What about conditions like lupus? Abstract 2861 evaluated how well the PREVENT risk calculator performs in patients with lupus.
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They used a large national database of patients with lupus between the ages of 30 to 79 during the period 2000 to 2021.
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They inputted different clinical variables into the calculator and estimated the PREVENT risk of total cardiovascular disease and heart failure.
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And what were the key findings? The PREVENT models seem to underperform or underestimate cardiovascular risk and heart failure at a moderate performance.
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The sensitivity to screen for heart failure was at around 53%, and the sensitivity to screen for total cardiovascular disease was 67%.
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And when it came to the predicted risk versus the observed risk, the predicted risk was lower than the observed risk across different deciles.
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So what's the key takeaway? The PREVENT score seems to underestimate the risk of cardiovascular disease in patients with lupus.
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And this complements findings from an earlier abstract presented on Sunday, abstract 0922, which also found a discrepancy between a low PREVENT score and the presence of coronary calcification in patients with lupus.
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Taken together, these abstracts do raise concern that the PREVENT score may underestimate true cardiovascular risk in patients with lupus.
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My takeaway is that calculating a risk score only tells part of the story.
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We also need to understand how well that score works in the patient that's sitting in front of us.
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And these findings do make me cautious about treating a low PREVENT score as reassurance in lupus.
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In my practice, I would interpret the score alongside the patient's lupus history, their disease activity, glucocorticoid use, as well as their antiphospholipid antibody status.
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And how to incorporate those factors into cardiovascular risk prediction remains an uncertain question.
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For now, my takeaway is that a low PREVENT score may not tell the whole story in lupus, and providing quality care means understanding the limitations of the tools and interpreting those results in the context of the patient in front of us.
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My name is Ekal Sud reporting from RheumNow. Thank you.
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