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
{"title":"AWARE一种快速评估2型糖尿病心血管风险的新型网络应用","authors":"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","doi":"10.1007/s00592-023-02115-x","DOIUrl":null,"url":null,"abstract":"<div><h3>Aim</h3><p>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.</p><h3>Methods</h3><p>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<sub>CVR</sub>), high (H<sub>CVR</sub>) and moderate (M<sub>CVR</sub>) 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.</p><h3>Results</h3><p>2243 T2DM consecutive patients were evaluated. 72.2% of the patients were VH<sub>CVR</sub>, 8.9% were H<sub>CVR</sub>, 0.8% were M<sub>CVR</sub> while 18.2% did not fit into any of the risk categories and were classified as “moderate-to-high” (MH<sub>CVR</sub>). Compared with the other groups, patients with VH<sub>CVD</sub> 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<sub>CVD</sub> 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<sub>CVR</sub> and to 24.7% of those with H<sub>CVR</sub>. Glycaemic control was unsatisfactory in this patients population (HbA1c 7.5 ± 3.4% [58.7 ± 13.4 mmol/mol]).\n</p><h3>Conclusions</h3><p>The AWARE App proved to be a practical tool for cardiovascular risk stratification of T2DM patients in real-world clinical practice.\n</p></div>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"60 9","pages":"1257 - 1266"},"PeriodicalIF":3.1000,"publicationDate":"2023-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00592-023-02115-x.pdf","citationCount":"0","resultStr":"{\"title\":\"AWARE A novel web application to rapidly assess cardiovascular risk in type 2 diabetes mellitus\",\"authors\":\"Cesare Berra, Roberto Manfrini, Marco Mirani, Loredana Bucciarelli, Ahmed S. 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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.</p><h3>Results</h3><p>2243 T2DM consecutive patients were evaluated. 72.2% of the patients were VH<sub>CVR</sub>, 8.9% were H<sub>CVR</sub>, 0.8% were M<sub>CVR</sub> while 18.2% did not fit into any of the risk categories and were classified as “moderate-to-high” (MH<sub>CVR</sub>). Compared with the other groups, patients with VH<sub>CVD</sub> 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<sub>CVD</sub> 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<sub>CVR</sub> and to 24.7% of those with H<sub>CVR</sub>. 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AWARE A novel web application to rapidly assess cardiovascular risk in type 2 diabetes mellitus
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 (VHCVR), high (HCVR) and moderate (MCVR) 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 VHCVR, 8.9% were HCVR, 0.8% were MCVR while 18.2% did not fit into any of the risk categories and were classified as “moderate-to-high” (MHCVR). Compared with the other groups, patients with VHCVD 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 MHCVD 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 VHCVR and to 24.7% of those with HCVR. 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.
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.
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