QRISK3 underestimates the risk of cardiovascular events in patients with COPD
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ..
BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) are at increased risk of cardiovascular disease (CVD). The extent to which the excess CVD risk is captured by risk factors in QRISK, a widely used CVD risk scoring tool, is not well studied.
METHODS: We created an incidence cohort of diagnosed COPD patients from the United Kingdom (UK) Clinical Practice Research Datalink GOLD database (January 1998-July 2018). The outcome was a composite of fatal or non-fatal CVD events. Sex-specific age-standardised incidence ratios (SIR) were compared with values for the UK primary-care population. The observed 10-year CVD risk was derived using the Kaplan-Meier estimator and was compared with predicted 10-year risk from the QRISK3 tool.
RESULTS: 13 208 patients (mean age 64.9 years, 45% women) were included. CVD incidence was 3.53 events per 100 person-years. The SIR of CVD was 1.71 (95% CI 1.61 to 1.75) in women and 1.62 (95%CI 1.54-1.64) in men. SIR was particularly high among patients younger than 65 years (women=2.13 (95% CI 1.94 to 2.19); men=1.86 (95% CI 1.74 to 1.90)). On average, the observed 10-year risk was 52% higher than QRISK predicted score (33.5% vs 22.1%). The difference was higher in patients younger than 65 years (observed risk 82% higher than predicted).
CONCLUSION: People living with COPD are at a significantly heightened risk of CVD over and beyond their predicted risk. This is particularly the case for younger people whose 10-year CVD risk can be >80% higher than predicted. Risk scoring tools must be validated and revised to provide accurate CVD predictions in patients with COPD.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2023 |
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| Enthalten in: |
Thorax - (2023) vom: 27. Nov. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Amegadzie, Joseph Emil [VerfasserIn] |
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Date Revised 05.12.2023 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1136/thorax-2023-220615 |
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NLM365411175 |
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| 245 | 1 | 0 | |a QRISK3 underestimates the risk of cardiovascular events in patients with COPD |
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| 520 | |a © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. | ||
| 520 | |a BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) are at increased risk of cardiovascular disease (CVD). The extent to which the excess CVD risk is captured by risk factors in QRISK, a widely used CVD risk scoring tool, is not well studied | ||
| 520 | |a METHODS: We created an incidence cohort of diagnosed COPD patients from the United Kingdom (UK) Clinical Practice Research Datalink GOLD database (January 1998-July 2018). The outcome was a composite of fatal or non-fatal CVD events. Sex-specific age-standardised incidence ratios (SIR) were compared with values for the UK primary-care population. The observed 10-year CVD risk was derived using the Kaplan-Meier estimator and was compared with predicted 10-year risk from the QRISK3 tool | ||
| 520 | |a RESULTS: 13 208 patients (mean age 64.9 years, 45% women) were included. CVD incidence was 3.53 events per 100 person-years. The SIR of CVD was 1.71 (95% CI 1.61 to 1.75) in women and 1.62 (95%CI 1.54-1.64) in men. SIR was particularly high among patients younger than 65 years (women=2.13 (95% CI 1.94 to 2.19); men=1.86 (95% CI 1.74 to 1.90)). On average, the observed 10-year risk was 52% higher than QRISK predicted score (33.5% vs 22.1%). The difference was higher in patients younger than 65 years (observed risk 82% higher than predicted) | ||
| 520 | |a CONCLUSION: People living with COPD are at a significantly heightened risk of CVD over and beyond their predicted risk. This is particularly the case for younger people whose 10-year CVD risk can be >80% higher than predicted. Risk scoring tools must be validated and revised to provide accurate CVD predictions in patients with COPD | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a COPD epidemiology | |
| 650 | 4 | |a Clinical Epidemiology | |
| 700 | 1 | |a Gao, Zhiwei |e verfasserin |4 aut | |
| 700 | 1 | |a Quint, Jennifer K |e verfasserin |4 aut | |
| 700 | 1 | |a Russell, Richard |e verfasserin |4 aut | |
| 700 | 1 | |a Hurst, John R |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Tae Yoon |e verfasserin |4 aut | |
| 700 | 1 | |a Sin, Don D |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Wenjia |e verfasserin |4 aut | |
| 700 | 1 | |a Bafadhel, Mona |e verfasserin |4 aut | |
| 700 | 1 | |a Sadatsafavi, Mohsen |e verfasserin |4 aut | |
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