Introduction: Diabetes mellitus (DM) is a major risk factor for cardiovascular (CV) events and coronary heart disease (CHD). Many algorithms are available to assess CV risk, some of which specific for diabetics. Most of them, however, can hardly be extrapolated to Mediterranean countries. Aim of the present study was to analyze CV risk and the incidence of events in a cohort of outpatients with type 2 DM living in Emilia Romagna. Methods: Clinical charts in the period 1991-1995 were analyzed. Diabetic patients aged 35-65 and no history of CV disease were eligible. Global risk was computed according to Framingham, RISKARD, Progetto Cuore and UKPDS algorithms and compared with the actual rate of events over the following 10 years. Results: 4337 patients were eligible. An absolute 10-yr rate of 9.8% was observed for CHD. Comparing patients with and without events, we found a significant (P < 0.05, Mann-Whitney U test) difference in several “classical” risk factors, plus duration of diabetes and HbA1c. Italian algorithms were more consistent with the observed data, but an underestimation of CV events was present, especially in females. Conclusions: Estimation of CV risk is dependent on the algorithm adopted and on the reference cohort. The performance of such functions is however low. Functions taking into account variables specific for diabetes severity should be adopted. The algorithm derived from the present study will be utilized for a prospective estimation of CV risk in our cohort.
CARDIOVASCULAR RISK IN PATIENTS WITH TYPE 2 DIABETES MELLITUS. EPIDEMIOLOGICAL STUDY IN A DIABETES CLINIC POPULATION OF NORTHERN ITALY
PASSARO, Angelina;FELLIN, Renato;
2012
Abstract
Introduction: Diabetes mellitus (DM) is a major risk factor for cardiovascular (CV) events and coronary heart disease (CHD). Many algorithms are available to assess CV risk, some of which specific for diabetics. Most of them, however, can hardly be extrapolated to Mediterranean countries. Aim of the present study was to analyze CV risk and the incidence of events in a cohort of outpatients with type 2 DM living in Emilia Romagna. Methods: Clinical charts in the period 1991-1995 were analyzed. Diabetic patients aged 35-65 and no history of CV disease were eligible. Global risk was computed according to Framingham, RISKARD, Progetto Cuore and UKPDS algorithms and compared with the actual rate of events over the following 10 years. Results: 4337 patients were eligible. An absolute 10-yr rate of 9.8% was observed for CHD. Comparing patients with and without events, we found a significant (P < 0.05, Mann-Whitney U test) difference in several “classical” risk factors, plus duration of diabetes and HbA1c. Italian algorithms were more consistent with the observed data, but an underestimation of CV events was present, especially in females. Conclusions: Estimation of CV risk is dependent on the algorithm adopted and on the reference cohort. The performance of such functions is however low. Functions taking into account variables specific for diabetes severity should be adopted. The algorithm derived from the present study will be utilized for a prospective estimation of CV risk in our cohort.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
