External validation of a multi-biomarker-based score for predicting risk of cardiovascular disease in patients with rheumatoid arthritis.

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  • Additional Information
    • Source:
      Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
    • Publication Information:
      Original Publication: San Francisco, CA : Public Library of Science
    • Subject Terms:
      Arthritis, Rheumatoid*/complications ; Arthritis, Rheumatoid*/blood ; Biomarkers*/blood ; Cardiovascular Diseases*/epidemiology; Humans ; Male ; Female ; Middle Aged ; Adult ; Proportional Hazards Models ; Aged ; Risk Factors ; Risk Assessment/methods ; Myocardial Infarction/epidemiology ; Cohort Studies
    • Abstract:
      Background: A multi-biomarker disease activity (MBDA)-based cardiovascular disease (CVD) risk score was developed and internally validated in a Medicare cohort to predict 3-year risk for myocardial infarction (MI), stroke or CVD death in patients with rheumatoid arthritis (RA). It combines the MBDA score, leptin, MMP-3, TNF-R1, age and four clinical variables. We are now externally validating it in a younger RA cohort.
      Methods: Claims data from a private aggregator were linked to MBDA test data to create a cohort of RA patients ≥18 years old. A univariable Cox proportional hazards regression model was fit using the MBDA-based CVD risk score as sole predictor of time-to-a-CVD event (hospitalized MI or stroke). Hazard ratio (HR) estimate was determined for all patients and for clinically relevant subgroups. A multivariable Cox model evaluated whether the MBDA-based CVD risk score adds predictive information to clinical data.
      Results: 49,028 RA patients (340 CVD events) were studied. Mean age was 52.3 years; 18.3% were male. HR for predicting 3-year risk of a CVD event by the MBDA-based CVD risk score in the full cohort was 3.99 (95% CI: 3.51-4.49, p = 5.0×10-95). HR were also significant for subgroups based on age, comorbidities, disease activity, and drug use. In a multivariable model, the MBDA-based CVD risk score added significant information to hypertension, diabetes, tobacco use, history of CVD, age, sex and CRP (HR = 2.27, p = 1.7×10-7).
      Conclusion: The MBDA-based CVD risk score has been externally validated in an RA cohort that is younger than and independent of the Medicare cohort that was used for development and internal validation.
      Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: ES, BM, DDFII, EH, CLC, RB-S, AG, and JSL are or were employed by Myriad Genetics during the conduct of the study and received salaries and may have received stock grants/options as compensation. EH has been employed by Labcorp. JC received grants or contracts from Abbvie, Amgen, BMS, Corevitas, Janssen, Lilly, Novartis, Myriad, Pfizer, Sanofi, Setpoint, Scipher, and UCB and received consulting fees from Abbvie, Amgen, BMS, Corevitas, Janssen, Lilly, Novartis, Myriad, Pfizer, Sanofi, Setpoint, Scipher, and UCB. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
      (Copyright: © 2024 Sasso et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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    • Accession Number:
      0 (Biomarkers)
    • Publication Date:
      Date Created: 20240506 Date Completed: 20240506 Latest Revision: 20240508
    • Publication Date:
      20240508
    • Accession Number:
      PMC11073667
    • Accession Number:
      10.1371/journal.pone.0296459
    • Accession Number:
      38709770