Objectives Cardiovascular (CV) disease is the leading cause of death among patients with systemic lupus erythematosus (SLE). This study aimed to compare the performance of QRESEARCH-risk estimator version 3 (QRISK3) and the Systematic Coronary Risk Evaluation-2 (SCORE2) scores to identify SLE patients at high risk of CV events, as indicated by the presence of carotid plaques. Methods Subclinical atherosclerosis was evaluated using carotid ultrasound in 365 SLE patients. QRISK3 and SCORE2 were calculated. The relationship between these scores and the presence of carotid plaques was analyzed by treating the scores as continuous and categorical variables, and separately and in combination. Logistic regression and area under the receiver operating characteristic curve (AUC) analyses were used to assess their predictive accuracy. Results The discriminatory capacity of QRISK3, with an AUC of 0.770 (95%CI : 0.720, 0.821), and SCORE2, with an AUC of 0.800 (95%CI : 0.753, 0.843), for carotid plaque was similar, with no statistically significant difference (p= 0.070). However, when examining the association of both calculators considered continuously and together with their interaction, the discriminatory capacity of this combination was significantly greater than that of QRISK3 alone (p= 0.034) but did not differ from SCORE2 (p= 0.71). Conclusion QRISK3 and SCORE2 are equally reliable predictors of carotid plaques in SLE patients. The combination of both calculators offers significantly better discrimination than QRISK3 alone but shows no significant difference when compared with SCORE2 alone. Therefore, SCORE2 alone, without the need for additional tools, can be used to identify patients with SLE who are at high risk of CV events.

中文翻译：

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QRISK3 和 SCORE2 是系统性红斑狼疮患者颈动脉斑块的可靠预测指标


目的 心血管 （CV） 疾病是系统性红斑狼疮 （SLE） 患者死亡的主要原因。本研究旨在比较 QRESEARCH-risk estimator version 3 （QRISK3） 和系统冠状动脉风险评估 2 （SCORE2） 评分的性能，以确定 SLE 患者在 CV 事件中的高风险，如颈动脉斑块的存在所示。方法 使用 365 例 SLE 患者的颈动脉超声评估亚临床动脉粥样硬化。计算 QRISK3 和 SCORE2。通过将评分视为连续变量和分类变量，以及单独和组合来分析这些评分与颈动脉斑块存在之间的关系。采用 Logistic 回归和受试者工作特征曲线下面积 （AUC） 分析来评估其预测准确性。结果 QRISK3 的鉴别能力（AUC 为 0.770 （95%CI： 0.720， 0.821）和 SCORE2 的 AUC 为 0.800 （95%CI： 0.753， 0.843），对颈动脉斑块的鉴别能力相似，无统计学意义差异 （p= 0.070）。然而，当检查连续考虑的两个计算器的关联以及它们的相互作用时，这种组合的区分能力显着大于单独的 QRISK3 （p = 0.034），但与 SCORE2 （p = 0.71） 没有差异。结论 QRISK3 和 SCORE2 是 SLE 患者颈动脉斑块的可靠预测指标。与单独的 QRISK3 相比，两种计算器的组合提供了明显更好的鉴别力，但与单独的 SCORE2 相比没有显示出显着差异。因此，无需额外工具，单独使用 SCORE2 即可用于识别 CV 事件高风险的 SLE 患者。