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Tools of Breunig et al to Screen a Patient with a Rheumatologic Disorder for Risk of Cardiovascular Disease and Death

Description

Some patients with a rheumatologic disorder may be at increased risk for cardiovascular events and death. Breunig et al listed tools to identify a patient who may benefit from a more complete evaluation of risk. The authors are from University Wurzburg and several clinics in Germany.


Patient selection: rheumatologic disorder (rheumatoid arthritis, psoriatic arthritis, other systemic autoimmune disease)

 

Outcome: cardiovascular event and/or death

 

Parameters:

(1) serum NT-proBNP in pg/mL

(2) European SCORE (Systematic Coronary Risk Evaluation)

(3) pathogenic changes on ECG (axis deviation; atrial fibrillation or flutter; pacemaker ECG; any degree of AB block; any bundle branch block; ischemic ST-segment changes; pathologic Sokolow-Lyon index; other)

 

A patient is at increased risk (3.5 to 5.0 fold) for cardiovascular event and/or death if one or both of the following are present:

(1) NT-proBNP >= 200 pg/mL

(2) European SCORE risk >= 3%

 

The presence of a pathogenic change in the ECG was assocaited with increased risk for mortality.


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