SCORE Plus Skin Autofluorescence More Accurately Assesses Cardiovascular Risk in RA

skin fluorescence
Researchers found data that showed cardiovascular risk in patients aged older than 55 years with rheumatoid arthritis can be accurately assessed using skin autoflourescence measurement.

Using a SCORE assessment with actual age combined with skin autofluorescence (SAF) may be a more accurate way of measuring cardiovascular risk (CVR) in patients with rheumatoid arthritis (RA), according to results published in the European Journal of Internal Medicine. Currently, Dutch guidelines recommend using the SCORE tool to assess CVR in people with RA. The SCORE tool includes adding 15 years to a patient’s actual age.

The study included consecutive adult participants who were diagnosed with RA and treated at the outpatient clinic of the department of rheumatology at Gelre Hospital in The Netherlands. Participants underwent a CVR assessment including the SCORE tool, SAF measurement, clinical history, physical examination, lipid profile, blood glucose testing, and kidney function measurement.

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The researchers categorized SAF measurement as normal, increased, or high CVR. They categorized the SCORE tool outcome as normal (<10% cardiovascular mortality and morbidity in the next 10 years), increased (10% to 20%), or high CVR (>20%). They then computed 3 by 3 tables to compare the risk assessment tools.

Of 79 participants, 66% (n=52) had a normal CVR according to the SAF risk assessment. With the SCORE assessment, 24% (n=19) of participants had a normal CVR with age adjustment of 15 years, while 61% (n=48) had a normal CVR without age adjustment.

With the SAF risk assessment, 14% (n=11) of participants had a high CVR compared with 63% (n=50) for the SCORE risk assessment with age adjustment of 15 years and 19% (n=15) without age adjustment.

The results indicated that the agreement between the SAF and SCORE risk assessments was 29% (23/79) with age adjustment and 48% (38/79) without.

“This is one of the first studies to assess SAF measurement in RA patients,” the researchers wrote. “Although our study population is small, the promising results warrant further investigation.”

Bakker-Aling SH, van Woerkom JK, Zomer TP, Buscher HCJL, van Bemmel T. Skin autofluorescence as a tool for cardiovascular risk estimation in patients with rheumatoid arthritis [published online June 25, 2019]. Eur J Intern Med. doi:10.1016/j.ejim.2019.06.011