Development and validation of an equation to predict the incidence of coronary heart disease in patients with type 2 diabetes in Japan

Abstract Objective: In the diabetes treatment policy after the Kumamoto Declaration 2013, it is difficult to accurately predict the incidence of complications in patients using the JJ risk engine. This study was conducted to develop a prediction equation suitable for the current diabetes treatment policy using patient data from Kitasato Institute Hospital (Hospital A) and to externally validate the developed equation using patient data from Kitasato University Hospital (Hospital B). Outlier tests were performed on the patient data from Hospital A to exclude the outliers. Prediction equation was developed using the patient data excluding the outliers and was subjected to external validation.Results: By excluding outlier data, we were able to develop a new prediction equation for the incidence of coronary heart disease (CHD) as a complication of type 2 diabetes, incorporating the use of antidiabetic drugs with a high risk of hypoglycemia. This is the first prediction equation in Japan that incorporates the use of antidiabetic drugs. We believe that it will be useful in preventive medicine for treatment for people at high risk of CHD as a complication of diabetes or other diseases. In the future, we would like to confirm the accuracy of this equation at other facilities.

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A retrospective study on the usefulness of the JJ risk engine for predicting the incidence rate of coronary heart disease in type 2 diabetes patients

BMC Research Notes ◽

10.1186/s13104-021-05508-9 ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Yasunari Yamashita ◽

Rina Kitajima ◽

Kiyoshi Matsubara ◽

Gaku Inoue ◽

Hajime Matsubara

Keyword(s):

Type 2 Diabetes ◽

Coronary Heart Disease ◽

Heart Disease ◽

Medical Records ◽

Low Frequency ◽

University Hospital ◽

Diabetes Treatment ◽

C Statistic ◽

Risk Engine

Abstract Objective In 2018, we conducted a retrospective survey using the medical records of 484 patients with type 2 diabetes. The observed value of coronary heart disease (CHD) incidence after 5 years and the predicted value by the JJ risk engine as of 2013 were compared and verified using the discrimination and calibration values. Results Among the total cases analyzed, the C-statistic was 0.588, and the calibration was p < 0.05; thus, the JJ risk engine could not correctly predict the risk of CHD. However, in the group expected to have a low frequency of hypoglycemia, the C-statistic was 0.646; the predictability of the JJ risk engine was relatively accurate. Therefore, it is difficult to accurately predict the complication rate of patients using the JJ risk engine based on the diabetes treatment policy after the Kumamoto Declaration 2013. The JJ risk engine has several input items (variables), and it is difficult to satisfy them all unless the environment is well-equipped with testing facilities, such as a university hospital. Therefore, it is necessary to create a new risk engine that requires fewer input items than the JJ risk engine and is applicable to several patients.

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Long-term Predictions of Incident Coronary Artery Calcium to 85 Years of Age for Asymptomatic Individuals with and without Type 2 Diabetes

10.2337/figshare.14365538 ◽

2021 ◽

Author(s):

Bart S. Ferket ◽

M.G. Myriam Hunink ◽

Umesh Masharani ◽

Wendy Max ◽

Joseph Yeboah ◽

...

Keyword(s):

Type 2 Diabetes ◽

Coronary Heart Disease ◽

Heart Disease ◽

Coronary Artery ◽

Coronary Artery Calcium ◽

Cardiovascular Events ◽

Diabetes Treatment ◽

The Impact

Objective To examine the utility of repeated computed tomography (CT) coronary artery calcium (CAC) testing, we assessed risks of detectable CAC and its cardiovascular consequences in individuals with and without type 2 diabetes from ages 45 to 85 years. Research Design and Methods We included 5836 individuals (618 with type 2 diabetes, 2972 without baseline CAC) from the Multi-Ethnic Study of Atherosclerosis. Logistic and Cox regression evaluated the impact of type 2 diabetes, diabetes treatment duration and other predictors on prevalent and incident CAC. We used time-dependent Cox modeling of follow-up data (median 15.9 years) for two repeat CT exams and cardiovascular events to assess the association of CAC at follow-up CT with cardiovascular events. Results For 45-year-olds with type 2 diabetes, the likelihood of CAC at baseline was 23% versus 17% for those without. Median age at incident CAC was 52.2 versus 62.3 years for those with and without diabetes. Each 5 years of diabetes treatment increased the odds and hazard rate of CAC by 19% (95% confidence interval [CI] 8-33%) and 22% (95% CI 6-41%). Male gender, white ethnicity/race, hypertension, hypercholesterolemia, obesity, and low serum creatinine also increased CAC. CAC at follow-up CT independently increased coronary heart disease rates. Conclusions We estimated cumulative CAC incidence to age 85. Patients with type 2 diabetes develop CAC at a younger age than those without diabetes. Because incident CAC is associated with increased coronary heart disease risk, the value of periodic CAC-based risk assessment in type 2 diabetes should be evaluated.

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Type 2 diabetes and a history of coronary heart disease are additive cardiovascular risks in high-risk hypertensive patients: a subanalysis of the CASE-J Ex

European Heart Journal ◽

10.1093/eurheartj/eht308.p1559 ◽

2013 ◽

Vol 34 (suppl 1) ◽

pp. P1559-P1559

Author(s):

S. Yasuno ◽

K. Ueshima ◽

S. Tanaka ◽

A. Fujimoto ◽

M. Kasahara ◽

...

Keyword(s):

Type 2 Diabetes ◽

Coronary Heart Disease ◽

Heart Disease ◽

High Risk ◽

Cardiovascular Risks ◽

Hypertensive Patients ◽

History Of

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RISK FACTORS OF CORONARY HEART DISEASE IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

Majalah Biomorfologi ◽

10.20473/mbiom.v32i1.2022.13-17 ◽

2022 ◽

Vol 32 (1) ◽

pp. 13

Author(s):

Elisabeth Sekaringtyas Medistya Putri ◽

Soebagijo Adi S ◽

Mohammad Budiarto

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Type 2 Diabetes ◽

Coronary Heart Disease ◽

Type 2 Diabetes Mellitus ◽

Heart Disease ◽

High Risk ◽

Academic Hospital ◽

Male Sex

Highlight:1. One of the major causes of morbidity and mortality in diabetes mellitus patients is coronary heart disease (CHD).2. The risk factors for coronary heart disease in type 2 diabetes mellitus patients were observed.3. The risk factors of CHD more commonly found in T2DM patients were high-risk age, male sex, hypertension and dyslipidemia.Abstract:Background: Diabetes mellitus is a metabolic syndrome that becomes a concern in almost all countries in the world, particularly developing countries. Changes in lifestyle and genetic factors are causing the incidence of this disease to continue to increase every year. Nowadays, type 2 diabetes mellitus (T2DM) caused by insulin resistance is the most common kind. One of its complications known as a major cause of morbidity and mortality in patients with diabetes is coronary heart disease (CHD). Insulin resistance can lead to the atherosclerosis process that is the basis of coronary heart disease. It is said that conditions of hyperglycemia, hypercoagulable state, and high cholesterol can induce the process of atherosclerosis. Besides diabetes mellitus, the other risk factors that increase the incidence of CHD are sex, age, family history, dyslipidemia, smoking, hypertension, and obesity. Objective: The purpose of this study was to describe the risk factors for coronary heart disease in patients with type 2 diabetes mellitus in Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. Materials and Methods: A cross-sectional study of diabetes mellitus patients with coronary heart disease was conducted in Dr. Soetomo General Academic Hospital from 1 January 2014 to 31 December 2014. Data were taken from medical records at the Department of Internal Medicine. Incomplete medical records were not included in this study. Risk factors analyzed were age, sex, history of hypertension and dyslipidemia. Results of this study were presented in a frequency distribution table. Results: Based on the data of 70 samples, risk factors of CHD in T2DM patients are found as follows: 44 (62.9%) samples were male, 56 (80%) high-risk aged group, 48 (68.6%) with dyslipidemia, and 50 (71.4%) with hypertension, while 24 (34.3%) samples had three risk factors at once. Conclusion: High-risk aged, male sex, hypertension, and dyslipidemia are more commonly found in T2DM patients with CHD. The more risk factors that one may have will increase the occurrence of cardiovascular disease within 10 years forward.

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Long-term Predictions of Incident Coronary Artery Calcium to 85 Years of Age for Asymptomatic Individuals with and without Type 2 Diabetes

10.2337/figshare.14365538.v1 ◽

2021 ◽

Author(s):

Bart S. Ferket ◽

M.G. Myriam Hunink ◽

Umesh Masharani ◽

Wendy Max ◽

Joseph Yeboah ◽

...

Keyword(s):

Type 2 Diabetes ◽

Coronary Heart Disease ◽

Heart Disease ◽

Coronary Artery ◽

Coronary Artery Calcium ◽

Cardiovascular Events ◽

Diabetes Treatment ◽

The Impact

Objective To examine the utility of repeated computed tomography (CT) coronary artery calcium (CAC) testing, we assessed risks of detectable CAC and its cardiovascular consequences in individuals with and without type 2 diabetes from ages 45 to 85 years. Research Design and Methods We included 5836 individuals (618 with type 2 diabetes, 2972 without baseline CAC) from the Multi-Ethnic Study of Atherosclerosis. Logistic and Cox regression evaluated the impact of type 2 diabetes, diabetes treatment duration and other predictors on prevalent and incident CAC. We used time-dependent Cox modeling of follow-up data (median 15.9 years) for two repeat CT exams and cardiovascular events to assess the association of CAC at follow-up CT with cardiovascular events. Results For 45-year-olds with type 2 diabetes, the likelihood of CAC at baseline was 23% versus 17% for those without. Median age at incident CAC was 52.2 versus 62.3 years for those with and without diabetes. Each 5 years of diabetes treatment increased the odds and hazard rate of CAC by 19% (95% confidence interval [CI] 8-33%) and 22% (95% CI 6-41%). Male gender, white ethnicity/race, hypertension, hypercholesterolemia, obesity, and low serum creatinine also increased CAC. CAC at follow-up CT independently increased coronary heart disease rates. Conclusions We estimated cumulative CAC incidence to age 85. Patients with type 2 diabetes develop CAC at a younger age than those without diabetes. Because incident CAC is associated with increased coronary heart disease risk, the value of periodic CAC-based risk assessment in type 2 diabetes should be evaluated.

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2436-PUB: Predicting Risk for New-Onset Type 2 Diabetes in Chinese People with Coronary Heart Disease and Impaired Glucose Tolerance

Diabetes ◽

10.2337/db19-2436-pub ◽

2019 ◽

Vol 68 (Supplement 1) ◽

pp. 2436-PUB

Author(s):

SHISHI XU ◽

CHARLES A. SCOTT ◽

RUTH L. COLEMAN ◽

JAAKKO TUOMILEHTO ◽

RURY R. HOLMAN

Keyword(s):

Type 2 Diabetes ◽

Coronary Heart Disease ◽

Heart Disease ◽

Glucose Tolerance ◽

Impaired Glucose Tolerance ◽

Chinese People ◽

Onset Type ◽

New Onset

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Mutations of mtDNA in some vascular and metabolic diseases

Current Pharmaceutical Design ◽

10.2174/1381612826999200820162154 ◽

2020 ◽

Vol 26 ◽

Author(s):

Margarita A. Sazonova ◽

Anastasia I. Ryzhkova ◽

Vasily V. Sinyov ◽

Marina D. Sazonova ◽

Tatiana V. Kirichenko ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Coronary Heart Disease ◽

Type 2 Diabetes Mellitus ◽

Heart Disease ◽

Chronic Diseases ◽

Metabolic Diseases ◽

Present Review ◽

Mtdna Mutations

Background: The present review article considers some chronic diseases of vascular and metabolic genesis, the causes of which may be mitochondrial dysfunction. Very often, in the long course of the disease, complications may occur, leading to myocardial infarction or ischemic stroke and as a result, death.In particular, a large percentage of human deaths nowadays belongs to cardiovascular diseases such as coronary heart disease (CHD), arterial hypertension, cardiomyopathies and type 2 diabetes mellitus. Objective: The aim of the present review was the analysis of literature sources, devoted to an investigation of a link of mitochondrial DNA mutations with chronic diseases of vascular and metabolic genesis, Results: The analysis of literature indicates the association of the mitochondrial genome mutations with coronary heart disease, type 2 diabetes mellitus, hypertension and various types of cardiomyopathies. Conclusion: The detected mutations can be used to analyze the predisposition to chronic diseases of vascular and metabolic genesis. They can also be used to create molecular-cell models necessary to evaluate the effectiveness of drugs developed for treatment of these pathologies. MtDNA mutations associated withthe absence of diseases of vascular and metabolic genesis could be potential candidates for gene therapy of diseases of vascular and metabolic genesis.

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