AWARE A novel web application to rapidly assess cardiovascular risk in type 2 diabetes mellitus

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Acta Diabetologica Pub Date : 2023-06-04 DOI:10.1007/s00592-023-02115-x

Cesare Berra, Roberto Manfrini, Marco Mirani, Loredana Bucciarelli, Ahmed S. Zakaria, Sara Piccini, Renata Ghelardi, Maria Elena Lunati, Sylka Rodovalho, Francesco Bifari, Paolo Fiorina, Franco Folli

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引用次数: 0

Abstract

Aim

To describe the development of the AWARE App, a novel web application for the rapid assessment of cardiovascular risk in Type 2 Diabetes Mellitus (T2DM) patients. We also tested the feasibility of using this App in clinical practice.

Methods

Based on 2019 European Society of Cardiology/European Association for the Study of Diabetes criteria for cardiovascular risk stratification in T2DM, the AWARE App classifies patients into very high (VH_CVR), high (H_CVR) and moderate (M_CVR) cardiovascular risk categories. In this retrospective clinical study, we employed the App to assess the cardiovascular risk of T2DM patients, while also collecting data about current glycaemic control and pharmacological treatment.

Results

2243 T2DM consecutive patients were evaluated. 72.2% of the patients were VH_CVR, 8.9% were H_CVR, 0.8% were M_CVR while 18.2% did not fit into any of the risk categories and were classified as “moderate-to-high” (MH_CVR). Compared with the other groups, patients with VH_CVD were more frequently ≥ 65 years old (68.9%), with a longer disease duration (≥ 10 years [56.8%]), a history of cardiovascular disease (41.4%), organ damage (35.5%) and a higher numbers of cardiovascular risk factors. Patients with MH_CVD generally had disease duration < 10 years (96%), younger age (50–60 years [55%]), no history of cardiovascular disease, no organ damage, and 1–2 cardiovascular risk factors (89%). Novel drugs such as Glucagon Like Peptyde 1 Receptor Agonists or Sodium-Glucose Linked Transporter 2 inhibitors were prescribed only to 26.3% of the patients with VH_CVR and to 24.7% of those with H_CVR. Glycaemic control was unsatisfactory in this patients population (HbA1c 7.5 ± 3.4% [58.7 ± 13.4 mmol/mol]).

Conclusions

The AWARE App proved to be a practical tool for cardiovascular risk stratification of T2DM patients in real-world clinical practice.

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AWARE一种快速评估2型糖尿病心血管风险的新型网络应用

目的描述AWARE应用程序的开发，这是一种用于快速评估2型糖尿病（T2DM）患者心血管风险的新型网络应用程序。我们还测试了在临床实践中使用该应用程序的可行性。方法根据2019年欧洲心脏病学会/欧洲糖尿病研究协会T2DM心血管风险分层标准，AWARE应用程序将患者分为极高（VHCVR）、高（HCVR）和中等（MCVR）心血管风险类别。在这项回顾性临床研究中，我们使用该应用程序来评估T2DM患者的心血管风险，同时收集有关当前血糖控制和药物治疗的数据。结果对2243例连续2型糖尿病患者进行了评估。72.2%的患者为VHCVR，8.9%为HCVR，0.8%为MCVR，18.2%不属于任何风险类别，被归类为“中度至高度”（MHCVR）。与其他组相比，VHCVD患者的发病率更高 ≥ 65岁（68.9%），病程较长（≥ 10年[56.8%]）、有心血管病史（41.4%）、器官损伤（35.5%）和较高数量的心血管危险因素。MHCVD患者通常有疾病持续时间 <； 10岁（96%），年龄较小（50-60岁[55%]），无心血管病史，无器官损伤，有1-2个心血管危险因素（89%）。仅26.3%的VHCVR患者和24.7%的HCVR患者使用了胰高血糖素样肽1受体激动剂或钠-葡萄糖连接转运蛋白2抑制剂等新药。该患者群体的血糖控制不令人满意（HbA1c 7.5 ± 3.4%[58.7 ± 13.4 mmol/mol]）。结论AWARE应用程序在实际临床实践中被证明是一种用于T2DM患者心血管风险分层的实用工具。

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来源期刊

Acta Diabetologica 医学-内分泌学与代谢

CiteScore

7.30

自引率

2.60%

发文量

180

审稿时长

2 months

期刊介绍： Acta Diabetologica is a journal that publishes reports of experimental and clinical research on diabetes mellitus and related metabolic diseases. Original contributions on biochemical, physiological, pathophysiological and clinical aspects of research on diabetes and metabolic diseases are welcome. Reports are published in the form of original articles, short communications and letters to the editor. Invited reviews and editorials are also published. A Methodology forum, which publishes contributions on methodological aspects of diabetes in vivo and in vitro, is also available. The Editor-in-chief will be pleased to consider articles describing new techniques (e.g., new transplantation methods, metabolic models), of innovative importance in the field of diabetes/metabolism. Finally, workshop reports are also welcome in Acta Diabetologica.