Investigation of the performance of validated cardiovascular risk scores in a global (UK/US) cohort of young people with childhood-onset systemic lupus erythematosus

[...]CVD-risk assessment guidelines recommend the evaluation of various traditional CVD-risk factors and use of CVD-risk scores, rather than vascular scans, for stratified management approaches in general population.3 The Atherosclerosis Prevention in Pediatric Lupus Erythematosus (APPLE) trial, a large interventional clinical trial in cSLE, evaluated the efficacy of atorvastatin in decreasing atherosclerosis progression in CYP aged 10–18 years, using serial CIMT measurements.4 Although the trial did not meet the primary endpoint, it provided us with the opportunity to discover a novel serum metabolomic signature associated with a high rate of atherosclerosis progression in cSLE.5 As CIMT measurements on vascular scans are not routinely implemented in clinical practice, we explored the comparative performance of four age-appropriate and validated CVD-risk scores in a global cSLE (UK/US) cohort to address a key research priority identified by our PPIE activities. Table 1 CVD-risk stratification of two independent cSLE cohorts cSLE patient cohorts stratified based on cross-validated metabolomic signatures of CIMT progression5 The UCL cohort (N=109) was stratified as: 29.2% low 48.3% moderate and 22.5% high CVD-risk The APPLE cohort (N=121) was stratified as: 28.5% low, 42.4% moderate and 29.1% high CVD-risk QRISK-3 score (N) 109 119 Very low QRISK-3 risk20% 7 (6.4%) 2 (1.7%) FRS score (N) 80 119 Very low FRS20% 0 0 ASCVD score (N) 62 80 Low ASCVD risk