Faculty Opinions recommendation of Cardiovascular risk prediction in type 2 diabetes before and after widespread screening: a derivation and validation study.

AbstractThe cardiovascular risk equations for diabetes patients from New Zealand and Chinese electronic health records (CREDENCE) study is a unique prospectively designed investigation of cardiovascular risk in two large contemporary cohorts of people with type 2 diabetes from New Zealand (NZ) and China. The study was designed to derive equivalent cardiovascular risk prediction equations in a developed and a developing country, using the same epidemiological and statistical methodology. Two similar cohorts of people with type 2 diabetes were identified from large general population studies in China and New Zealand, which had been generated from longitudinal electronic health record systems. The CREDENCE study aims to determine whether cardiovascular risk prediction equations derived in patients with type 2 diabetes in a developed country are applicable in a developing country, and vice versa, by deriving and validating equivalent diabetes-specific cardiovascular risk prediction models from the two countries. Baseline data in CREDENCE was collected from October 2004 in New Zealand and from January 2010 in China. In the first stage of CREDENCE, a total of 93,207 patients (46,649 from NZ and 46,558 from China) were followed until December 31st 2018. Median follow-up was 7.0 years (New Zealand) and 5.7 years (China). There were 5926 (7.7% fatal) CVD events in the New Zealand cohort and 3650 (8.8% fatal) in the Chinese cohort. The research results have implications for policy makers, clinicians and the public and will facilitate personalised management of cardiovascular risk in people with type 2 diabetes worldwide.

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Study of Cardiovascular Risk Prediction in Patients with Type 2 Diabetes with Arterial Hypertension after Combined Hypotensive Therapy of Enalapril with Moxonidine

International Journal of Current Research and Review ◽

10.31782/ijcrr.2020.121623 ◽

2020 ◽

Vol 12 (16) ◽

pp. 139-144

Author(s):

Zumrad Ergasheva ◽

Bustanov Sherzodbek ◽

Bakhtiyorjon Jurabaev ◽

Mamurjon Turgunov ◽

Mukhayyo Akhmatokhunova

Keyword(s):

Type 2 Diabetes ◽

Cardiovascular Risk ◽

Arterial Hypertension ◽

Risk Prediction ◽

Cardiovascular Risk Prediction ◽

Hypotensive Therapy

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Cardiovascular risk prediction in type 2 diabetes: a comparison of 22 risk scores in primary care setting

10.1101/2020.10.08.20209015 ◽

2020 ◽

Author(s):

K Dziopa ◽

F W Asselbergs ◽

J Gratton ◽

N Chaturvedi ◽

A F Schmidt

Keyword(s):

Type 2 Diabetes ◽

Cardiovascular Risk ◽

Risk Prediction ◽

Risk Scores ◽

Routine Practice ◽

Cvd Risk ◽

C Statistic ◽

Cardiovascular Risk Prediction ◽

Multiple Variables

AbstractObjectiveTo compare performance of general and diabetes specific cardiovascular risk prediction scores in type 2 diabetes patients (T2DM).DesignCohort study.SettingScores were identified through a systematic review and included irrespective of predicted outcome, or inclusion of T2DM patients. Performance was assessed using data from routine practice.ParticipantsA contemporary representative sample of 203,172 UK T2DM patients (age ≥ 18 years).Main outcome measuresCardiovascular disease (CVD i.e., coronary heart disease and stroke) and CVD+ (including atrial fibrillation and heart failure).ResultsWe identified 22 scores: 11 derived in the general population, 9 in only T2DM patients, and 2 that excluded T2DM patients. Over 10 years follow-up, 63,000 events occurred. The RECODE score, derived in people with T2DM, performed best for both CVD (c-statistic 0.731 (0.728,0.734), and CVD+ (0.732 (0.729,0.735)). Overall, neither derivation population, nor original predicted outcome influenced performance. Calibration slopes (1 indicates perfect calibration) ranged from 0.38 (95%CI 0.37;0.39) to 1.05 (95%CI 1.03;1.07). A simple, population specific recalibration process considerably improved performance, ranging between 0.98 and 1.03. Risk scores performed badly in people with pre-existing CVD (c-statistic ∼0.55). Scores with more predictors did not perform scores better: for CVD+ QRISK3 (19 variables) c-statistic 0.69 (95%CI 0.68;0.69), compared to CHD Basic (8 variables) 0.71 (95%CI 0.70; 0.71).ConclusionsCVD risk prediction scores performed well in T2DM, irrespective of derivation population and of original predicted outcome. Scores performed poorly in patients with established CVD. Complex scores with multiple variables did not outperform simple scores. A simple population specific recalibration markedly improved score performance and is recommended for future use.

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