{"title":"系统冠状动脉风险评估 2-糖尿病风险模型和动脉僵化对亚洲 2 型糖尿病患者心血管事件的预测价值。","authors":"Pannipa Suwannasom, Tasalak Thonghong, Krit Leemasawat, Teerapat Nantsupawat, Narawudt Prasertwitayakij, Chutamas Pairoj, Wanwarang Wongcharoen, Arintaya Phrommintikul, CORE-Thailand Investigators","doi":"10.1111/jdi.14231","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aims/Introduction</h3>\n \n <p>Individuals with diabetes are at high risk of developing cardiovascular events. The present study investigated the predictive value of the cardio-ankle vascular index (CAVI) when added to the Systematic Coronary Risk Evaluation 2-Diabetes (SCORE2-Diabetes) risk algorithm to predict cardiovascular events in the Asian population.</p>\n </section>\n \n <section>\n \n <h3> Materials and Methods</h3>\n \n <p>The SCORE2-Diabetes risk was assessed in 1,502 patients with diabetes, aged 40–69 years. Then, we further stratified each 10-year risk category with a CAVI value of 9.0. The primary outcomes (composite of all causes of death, myocardial infarction, stroke and hospitalization for heart failure) were assessed over 5 years.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The mean age of the population was 59.8 ± 6.4 years. The proportion of 10-year risk according to the SCORE2-Diabetes risk of low, moderate, high and very high risk identified at 7.2, 30.0, 27.2 and 35.6%, respectively. The mean CAVI value was 8.4 ± 1.4, and approximately 35.4% of the patients had CAVI ≥9.0. The SCORE2-Diabetes risk algorithm independently predicted the primary outcomes in patients with diabetes (hazard ratio 1.18, 95% confidence interval [CI] 1.13–1.22), whereas CAVI did not (hazard ratio 1.03, 95% CI 0.89–1.18). The C-index for the primary outcomes of the SCORE2-Diabetes risk algorithm alone was 0.72 (95% CI 0.67–0.77). The combination of SCORE2-Diabetes and CAVI, both in the continuous value and risk groups, did not improve discrimination (C-index 0.72, 95% CI 0.67–0.77 and 0.68, 95% CI 0.64–0.74, respectively).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Adding the CAVI to the SCORE2-Diabetes risk algorithm did not improve individual risk stratification in patients with diabetes.</p>\n </section>\n </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"15 9","pages":"1266-1275"},"PeriodicalIF":3.1000,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363117/pdf/","citationCount":"0","resultStr":"{\"title\":\"Predictive value of Systematic Coronary Risk Evaluation 2-Diabetes risk model and arterial stiffness for cardiovascular events in the Asian population with type 2 diabetes mellitus\",\"authors\":\"Pannipa Suwannasom, Tasalak Thonghong, Krit Leemasawat, Teerapat Nantsupawat, Narawudt Prasertwitayakij, Chutamas Pairoj, Wanwarang Wongcharoen, Arintaya Phrommintikul, CORE-Thailand Investigators\",\"doi\":\"10.1111/jdi.14231\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Aims/Introduction</h3>\\n \\n <p>Individuals with diabetes are at high risk of developing cardiovascular events. 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The mean CAVI value was 8.4 ± 1.4, and approximately 35.4% of the patients had CAVI ≥9.0. The SCORE2-Diabetes risk algorithm independently predicted the primary outcomes in patients with diabetes (hazard ratio 1.18, 95% confidence interval [CI] 1.13–1.22), whereas CAVI did not (hazard ratio 1.03, 95% CI 0.89–1.18). The C-index for the primary outcomes of the SCORE2-Diabetes risk algorithm alone was 0.72 (95% CI 0.67–0.77). 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引用次数: 0
摘要
目的/简介：糖尿病患者发生心血管事件的风险很高。本研究调查了心踝关节血管指数（CAVI）加入系统冠状动脉风险评估 2-糖尿病（SCORE2-Diabetes）风险算法后对预测亚洲人群心血管事件的预测价值：对 1,502 名 40-69 岁的糖尿病患者进行了 SCORE2-Diabetes 风险评估。然后，我们对 CAVI 值为 9.0 的每个 10 年风险类别进行了进一步分层。主要结果（所有死亡原因、心肌梗死、中风和心力衰竭住院治疗的综合结果）的评估历时5年：研究对象的平均年龄为（59.8 ± 6.4）岁。根据 SCORE2-糖尿病低、中、高和极高风险确定的 10 年风险比例分别为 7.2%、30.0%、27.2% 和 35.6%。CAVI 平均值为 8.4 ± 1.4，约 35.4% 的患者 CAVI ≥9.0。SCORE2-糖尿病风险算法可独立预测糖尿病患者的主要预后（危险比 1.18，95% 置信区间 [CI] 1.13-1.22），而 CAVI 不能（危险比 1.03，95% CI 0.89-1.18）。单独使用 SCORE2-糖尿病风险算法的主要结果的 C 指数为 0.72（95% CI 0.67-0.77）。在连续值组和风险组中，SCORE2-糖尿病和CAVI的组合并未提高辨别能力（C指数分别为0.72，95% CI 0.67-0.77和0.68，95% CI 0.64-0.74）：结论：在SCORE2-糖尿病风险算法中加入CAVI并不能改善糖尿病患者的个体风险分层。
Predictive value of Systematic Coronary Risk Evaluation 2-Diabetes risk model and arterial stiffness for cardiovascular events in the Asian population with type 2 diabetes mellitus
Aims/Introduction
Individuals with diabetes are at high risk of developing cardiovascular events. The present study investigated the predictive value of the cardio-ankle vascular index (CAVI) when added to the Systematic Coronary Risk Evaluation 2-Diabetes (SCORE2-Diabetes) risk algorithm to predict cardiovascular events in the Asian population.
Materials and Methods
The SCORE2-Diabetes risk was assessed in 1,502 patients with diabetes, aged 40–69 years. Then, we further stratified each 10-year risk category with a CAVI value of 9.0. The primary outcomes (composite of all causes of death, myocardial infarction, stroke and hospitalization for heart failure) were assessed over 5 years.
Results
The mean age of the population was 59.8 ± 6.4 years. The proportion of 10-year risk according to the SCORE2-Diabetes risk of low, moderate, high and very high risk identified at 7.2, 30.0, 27.2 and 35.6%, respectively. The mean CAVI value was 8.4 ± 1.4, and approximately 35.4% of the patients had CAVI ≥9.0. The SCORE2-Diabetes risk algorithm independently predicted the primary outcomes in patients with diabetes (hazard ratio 1.18, 95% confidence interval [CI] 1.13–1.22), whereas CAVI did not (hazard ratio 1.03, 95% CI 0.89–1.18). The C-index for the primary outcomes of the SCORE2-Diabetes risk algorithm alone was 0.72 (95% CI 0.67–0.77). The combination of SCORE2-Diabetes and CAVI, both in the continuous value and risk groups, did not improve discrimination (C-index 0.72, 95% CI 0.67–0.77 and 0.68, 95% CI 0.64–0.74, respectively).
Conclusions
Adding the CAVI to the SCORE2-Diabetes risk algorithm did not improve individual risk stratification in patients with diabetes.
期刊介绍：
Journal of Diabetes Investigation is your core diabetes journal from Asia; the official journal of the Asian Association for the Study of Diabetes (AASD). The journal publishes original research, country reports, commentaries, reviews, mini-reviews, case reports, letters, as well as editorials and news. Embracing clinical and experimental research in diabetes and related areas, the Journal of Diabetes Investigation includes aspects of prevention, treatment, as well as molecular aspects and pathophysiology. Translational research focused on the exchange of ideas between clinicians and researchers is also welcome. Journal of Diabetes Investigation is indexed by Science Citation Index Expanded (SCIE).
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