{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T10:10:22Z","timestamp":1790676622163,"version":"4.1.0"},"reference-count":39,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2023,8,9]],"date-time":"2023-08-09T00:00:00Z","timestamp":1691539200000},"content-version":"unspecified","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2023,7,28]]},"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>To examine blood pressure (BP) and lipid treatment eligibility in antiphospholipid syndrome (APS) according to European Alliance of Associations for Rheumatology (EULAR) and European Society of Cardiology (ESC) recommendations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Systematic Coronary Risk Evaluation (SCORE), modified-SCORE, diabetes mellitus (DM)-equivalent risk classifiers (DIME) and disease-related classifiers \u2013type of thrombotic events (APS<jats:sub>events<\/jats:sub>), antiphospholipid-antibody profile (aPL<jats:sub>profile<\/jats:sub>) and adjusted Global APS Score for cardiovascular disease\u2013 were used to calculate predicted low-moderate, high and very-high cardiovascular risk (CVR) in 111 patients with APS without prior atherosclerotic cardiovascular events or DM. Actual CVR (AR) was determined according to ESC guidelines, including carotid\/femoral plaque presence. In low-moderate SCORE-predicted risk patients, classification ability and agreement for BP or lipid treatment was tested with Matthews\u2019 correlation coefficient (MCC) and Cohen\u2019s kappa, respectively, using the AR classes as reference qualifiers.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>SCORE underestimated high\/very-high-AR in &gt;50% of cases. SCORE-guided BP\/lipid treatment eligibility was 4.2%\/12.6% for high, 10.5%\/16.8% for very-high AR patients, while 5.3% of low-moderate AR cases were eligible for lipid-lowering therapy. For BP treatment, MCC was higher using DIME for low-moderate and very-high-risk (0.33 and 0.32, respectively), and using modified-SCORE+APS<jats:sub>events<\/jats:sub> (MCC=0.25) for high-risk patients. Eligibility agreement was better with DIME+APS<jats:sub>events<\/jats:sub>\u2009or aPL<jats:sub>profile<\/jats:sub> (kappa=0.51) for high-risk, and DIME (kappa=0.31) for very-high-risk patients. For lipid treatment, both classification ability and eligibility agreement were stronger with SCORE (or modified-SCORE)+APS<jats:sub>events<\/jats:sub> in low-moderate (MCC\/kappa=0.43\/0.41) and very-high risk (MCC\/kappa=0.30\/0.30), and with DIME+aPL<jats:sub>profile<\/jats:sub> (MCC\/kappa=0.50\/0.50) in high-risk patients, respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Multimodal risk assessment including disease-related and cardiometabolic features used for high-risk diseases such as DM can improve CVR management in APS.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2023-003326","type":"journal-article","created":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T06:10:38Z","timestamp":1694067038000},"page":"e003326","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Application of EULAR and European Society of Cardiology recommendations with regard to blood pressure and lipid management in antiphospholipid syndrome"],"prefix":"10.1136","volume":"9","author":[{"given":"George C","family":"Drosos","sequence":"first","affiliation":[{"name":"Cardiovascular Risk Research Laboratory, First Department of Propaedeutic Internal Medicine, National and Kapodistrian University of Athens School of Medicine, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Konstantonis","sequence":"additional","affiliation":[{"name":"Cardiovascular Risk Research Laboratory, First Department of Propaedeutic Internal Medicine, National and Kapodistrian University of Athens School of Medicine, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petros P","family":"Sfikakis","sequence":"additional","affiliation":[{"name":"Cardiovascular Risk Research Laboratory, First Department of Propaedeutic Internal Medicine, National and Kapodistrian University of Athens School of Medicine, Athens, Greece"},{"name":"Rheumatology Unit, First Department of Propaedeutic Internal Medicine, National and Kapodistrian University of Athens School of Medicine, Athens, Greece"},{"name":"Joint Academic Rheumatology Program, National and Kapodistrian University of Athens School of Medicine, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2238-0975","authenticated-orcid":false,"given":"Maria G","family":"Tektonidou","sequence":"additional","affiliation":[{"name":"Cardiovascular Risk Research Laboratory, First Department of Propaedeutic Internal Medicine, National and Kapodistrian University of Athens School of Medicine, Athens, Greece"},{"name":"Rheumatology Unit, First Department of Propaedeutic Internal Medicine, National and Kapodistrian University of Athens School of Medicine, Athens, Greece"},{"name":"Joint Academic Rheumatology Program, National and 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