VPB0515 - Assessing the cardiovascular risk in patients with Systemic Lupus Erythematosus: QRISK and GAPSS scores head to head

Background: Assessing the cardiovascular risk in SLE patients is fundamental in the clinical practice. Recently, the QRISK3 score has attempted to encompass for SLE augmented risk by adding items (e.g. corticosteroid use) that are missing in traditional CVD risk-scores.

Aims: To apply/compare QRISK3 and adjusted Global AntiPhospholipid Syndrome Score (aGAPSS), a validated score to assess CVD risk in aPL-positive patients, in a cohort of SLE patients.

Methods: 25-85 years old patients with a confirmed diagnosis of SLE and/or of SAPS were recruited during a period of 6 months (Sep2019–Feb2020). QRISK3 was calculated using the official online calculator (https://qrisk.org/) and aGAPSS was calculated using the validated point values: aCL=5, aβ2GPI=4, LA=4, aPS/PT=3, hyperlipidemia=3, hypertension=1.

Results: The analysis included 142 SLE patients: 34 SAPS(23.9%) and 108 SLE patients without APS(76.1%) [mean age=48±12.9(SAPS=51.6±12.8/SLE without APS=46.9±12.8)]. Table 1 summarizes patients characteristics. When focusing on cerebrovascular/coronary events, we found a statistical significance for aGAPSS (with event=10.1±6.2 vs. without event=5.8±6.1; p=0.007), but not QRISK3. A significant association was observed between the occurrence of these events and high-risk aGAPSS: p=0.03 for aGAPSS≥8, p=0.01 for aGAPSS≥9, p=0.008 for aGAPSS≥10. aGAPSS but not QRISK3 strongly correlated with any thrombotic event occurrence, both at the uni- and multivariate analysis (univariate: with event=8.17±7.1 vs. without event=5.41±5.6; p=0.012 /multivariate: p=0.009). Male gender correlated with any thrombotic event occurrence both at uni- and multivariate(p=0.017 and p=0.03). When focusing on aPL-profile, regardless the diagnosis, we found a statistical significance only with respect to aGAPSS(aPL+ =9.6±6.3 vs. aPL- =4.1±5.1; p< 0.001).

Conclusion(s): Our study showed that aGAPSS is the most valuable tool for assessing CVD risk in SLE patients. Adding the aPL-profile as an item to the QRISK3 could be a useful strategy to improve it when considering patients with autoimmune diseases.