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Development and validation of a total coronary heart disease risk score in type 2 diabetes mellitus.
Am J Cardiol. 2008 Mar 01; 101(5):596-601.AJ

Abstract

There are no validated risk scores for predicting coronary heart disease (CHD) in Chinese patients with type 2 diabetes mellitus. This study aimed to validate the UKPDS risk engine and, if indicated, develop CHD risk scores. A total of 7,067 patients without CHD at baseline were analyzed. Data were randomly assigned to a training data set and a test data set. Cox models were used to develop risk scores to predict total CHD in the training data set. Calibration was assessed using the Hosmer-Lemeshow test, and discrimination was examined using the area under the receiver-operating characteristic curve in the test data set. During a median follow-up of 5.40 years, 4.97% of patients (n = 351) developed incident CHD. The UKPDS CHD risk engine overestimated the risk of CHD with suboptimal discrimination, and a new total CHD risk score was developed. The developed total CHD risk score was 0.0267 x age (years) - 0.3536 x sex (1 if female) + 0.4373 x current smoking status (1 if yes) + 0.0403 x duration of diabetes (years) - 0.4808 x Log(10) (estimated glomerular filtration rate [ml/min/1.73 m(2)]) + 0.1232 x Log(10) (1 + spot urinary albumin-creatinine ratio [mg/mmol]) + 0.2644 x non-high-density lipoprotein cholesterol (mmol/L). The 5-year probability of CHD = 1 - 0.9616(EXP(0.9440 x [RISK SCORE - 0.7082])). Predicted CHD probability was not significantly different from observed total CHD probability, and the adjusted area under the receiver-operating characteristic curve was 0.74 during 5 years of follow-up. In conclusion, the UKPDS CHD risk engine overestimated the risk of Chinese patients with type 2 diabetes mellitus and the newly developed total CHD risk score performed well in the test data set. External validations are required in other Chinese populations.

Authors+Show Affiliations

Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, SAR, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Validation Study

Language

eng

PubMed ID

18308005

Citation

Yang, Xilin, et al. "Development and Validation of a Total Coronary Heart Disease Risk Score in Type 2 Diabetes Mellitus." The American Journal of Cardiology, vol. 101, no. 5, 2008, pp. 596-601.
Yang X, So WY, Kong AP, et al. Development and validation of a total coronary heart disease risk score in type 2 diabetes mellitus. Am J Cardiol. 2008;101(5):596-601.
Yang, X., So, W. Y., Kong, A. P., Ma, R. C., Ko, G. T., Ho, C. S., Lam, C. W., Cockram, C. S., Chan, J. C., & Tong, P. C. (2008). Development and validation of a total coronary heart disease risk score in type 2 diabetes mellitus. The American Journal of Cardiology, 101(5), 596-601. https://doi.org/10.1016/j.amjcard.2007.10.019
Yang X, et al. Development and Validation of a Total Coronary Heart Disease Risk Score in Type 2 Diabetes Mellitus. Am J Cardiol. 2008 Mar 1;101(5):596-601. PubMed PMID: 18308005.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Development and validation of a total coronary heart disease risk score in type 2 diabetes mellitus. AU - Yang,Xilin, AU - So,Wing-Yee, AU - Kong,Alice P S, AU - Ma,Ronald C W, AU - Ko,Gary T C, AU - Ho,Chung-Shun, AU - Lam,Christopher W K, AU - Cockram,Clive S, AU - Chan,Juliana C N, AU - Tong,Peter C Y, Y1 - 2007/12/21/ PY - 2007/09/07/received PY - 2007/10/09/revised PY - 2007/10/09/accepted PY - 2008/3/1/pubmed PY - 2008/4/11/medline PY - 2008/3/1/entrez SP - 596 EP - 601 JF - The American journal of cardiology JO - Am J Cardiol VL - 101 IS - 5 N2 - There are no validated risk scores for predicting coronary heart disease (CHD) in Chinese patients with type 2 diabetes mellitus. This study aimed to validate the UKPDS risk engine and, if indicated, develop CHD risk scores. A total of 7,067 patients without CHD at baseline were analyzed. Data were randomly assigned to a training data set and a test data set. Cox models were used to develop risk scores to predict total CHD in the training data set. Calibration was assessed using the Hosmer-Lemeshow test, and discrimination was examined using the area under the receiver-operating characteristic curve in the test data set. During a median follow-up of 5.40 years, 4.97% of patients (n = 351) developed incident CHD. The UKPDS CHD risk engine overestimated the risk of CHD with suboptimal discrimination, and a new total CHD risk score was developed. The developed total CHD risk score was 0.0267 x age (years) - 0.3536 x sex (1 if female) + 0.4373 x current smoking status (1 if yes) + 0.0403 x duration of diabetes (years) - 0.4808 x Log(10) (estimated glomerular filtration rate [ml/min/1.73 m(2)]) + 0.1232 x Log(10) (1 + spot urinary albumin-creatinine ratio [mg/mmol]) + 0.2644 x non-high-density lipoprotein cholesterol (mmol/L). The 5-year probability of CHD = 1 - 0.9616(EXP(0.9440 x [RISK SCORE - 0.7082])). Predicted CHD probability was not significantly different from observed total CHD probability, and the adjusted area under the receiver-operating characteristic curve was 0.74 during 5 years of follow-up. In conclusion, the UKPDS CHD risk engine overestimated the risk of Chinese patients with type 2 diabetes mellitus and the newly developed total CHD risk score performed well in the test data set. External validations are required in other Chinese populations. SN - 0002-9149 UR - https://www.unboundmedicine.com/medline/citation/18308005/Development_and_validation_of_a_total_coronary_heart_disease_risk_score_in_type_2_diabetes_mellitus_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(07)02126-1 DB - PRIME DP - Unbound Medicine ER -