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01.11.2014 | Article

Development of a prediction model for fatal and non-fatal coronary heart disease and cardiovascular disease in patients with newly diagnosed type 2 diabetes mellitus: The Basque Country Prospective Complications and Mortality Study risk engine (BASCORE)

verfasst von: José A. Piniés, Fernando González-Carril, José M. Arteagoitia, Itziar Irigoien, Jone M. Altzibar, José L. Rodriguez-Murua, Larraitz Echevarriarteun, the Sentinel Practice Network of the Basque Country

Erschienen in: Diabetologia | Ausgabe 11/2014

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Abstract

Aims/hypothesis

The aim of this study was to construct a model for predicting CHD and cardiovascular disease (CVD) risk in patients with newly diagnosed type 2 diabetes in a southern European region. External validation of two other cardiovascular risk models and internal validation of our model were assessed.

Methods

We studied 65,651 people attending a primary care setting in the Basque Country Health Service. A 10-year prospective population-based cohort study was performed with 777 patients newly diagnosed with type 2 diabetes older than 24 years in a Sentinel Practice Network. Cardiovascular risk factors, CVD events and mortality were registered. Coefficients for the significant predictors of CHD and CVD were estimated using Cox models. We assessed the discrimination and calibration of the UK Prospective Diabetes Study risk engine (UKPDS-RE), the Framingham Risk Score-Regicor Study (FRS-RS) and the cardiovascular risk model we developed.

Results

The incidence rate per 1,000 patients/year was calculated for microvascular and cardiovascular complications, and death. Age, the ratio of non-HDL- to HDL-cholesterol, HbA_1c, systolic blood pressure and smoking were significant predictors of cardiovascular events. A risk model was developed using these predictors. The UKPDS-RE and FRS-RS showed inadequate discrimination (Uno’s C statistics 0.62 and 0.58, respectively) and calibration (24% overestimation and 51% underestimation, respectively) for predicting CHD risk. The internal discrimination and calibration of the developed model were acceptable for predicting fatal/non-fatal 2- and 5-, but not 10-year CHD and CVD risk.

Conclusions/interpretation

This study is the first southern European validated population-derived model for predicting 5-year fatal/non-fatal CHD and CVD risk in patients with newly diagnosed type 2 diabetes.

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Titel: Development of a prediction model for fatal and non-fatal coronary heart disease and cardiovascular disease in patients with newly diagnosed type 2 diabetes mellitus: The Basque Country Prospective Complications and Mortality Study risk engine (BASCORE)
verfasst von: José A. Piniés
Fernando González-Carril
José M. Arteagoitia
Itziar Irigoien
Jone M. Altzibar
José L. Rodriguez-Murua
Larraitz Echevarriarteun
the Sentinel Practice Network of the Basque Country
Publikationsdatum: 01.11.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: Diabetologia / Ausgabe 11/2014
Print ISSN: 0012-186X
Elektronische ISSN: 1432-0428
DOI: https://doi.org/10.1007/s00125-014-3370-1

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Development of a prediction model for fatal and non-fatal coronary heart disease and cardiovascular disease in patients with newly diagnosed type 2 diabetes mellitus: The Basque Country Prospective Complications and Mortality Study risk engine (BASCORE)

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Methods

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