New Diabetes-Specific CVD Risk Score: Development and Validation

Researchers have developed diabetes mellitus (DM)-specific risk score that demonstrates efficacy in assessing the risk of cardiovascular disease (CVD) in diabetic patients.

“Existing CVD risk scores used in diabetes mellitus (DM) patients may be outdated, derived from single or clinical trial cohort, or designed for one endpoint,” the researchers said in an abstract, the results of which were presented at the American Heart Association 2019 Scientific Sessions in Philadelphia. “We aimed to develop a set of risk scores for total CVD and its separate components of coronary heart disease (CHD), heart failure (HF) and stroke.”

The authors pooled 4,183 CVD-free adults with DM (aged 30-86, 45% male, 45% Black) from five US population-based cohorts: Atherosclerosis Risk in Communities Study (ARIC), the Multi-Ethnic Study of Atherosclerosis (MESA), the Coronary Artery Risk Development in Young Adults Study, the Jackson Heart Study, and the Framingham Heart Study Offspring cohorts. Subsequently, they developed 10-year risk scores for total CVD, which included myocardial infarction, cardiac revascularization, stroke, HF, peripheral artery disease, and CVD health, as well as individual components of coronary heart disease (CHD), HF, and stroke.

The results of the study showed that the average predicted 10-year risks were 21.8% for CVD, 12.7% for CHD, 9.8% for HF, and 5.8% for stroke. The risk scores were deemed to have a strong internal discrimination and calibration (c-statistics: 0.70-0.76; calibration slopes: 1.03-1.17 comparing observed vs. predicted risk). In the ACCORD cohort, the new scores showed superior performance over FRS and UKPDS (c-statistics 0.62-0.71 vs. 0.55-0.60), with net reclassification improvement between 0.03 and 0.26.

“Our DM-specific CVD risk score based on pooled-data from five cohorts demonstrated good predictive performance and may be useful for assessing the risk of CVD and its components in US adults with DM,” the authors concluded.