SYSTEM FOR THE NEAREST CARDIOVASCULAR RISK ASSESSMENT IN SECOND TYPE DIABETES PATIENTS
https://doi.org/10.15829/1560-4071-2016-4-30-34
Abstract
All recently known scores are applicable for long-term cardiovascular prognosis (CVP) for ≥10 years, and do underestimate the risk cardiovascular diseases (CVD) in persons with second type diabetes (DM). For the real clinical practice there is demand for CVD prediction in the nearest future.
Aim. To develop a system for the nearest risk assessment for stroke and myocardial infarction (MI) in DM patients on the ground of clinical risk factors.
Material and methods. Patients with DM from the Altai Region registry were selected to 2 groups: non-stroke and non-MI (1st group) and those after stroke and MI in the year 2014 (2nd group, comparison).
Results. Mono- and multifactorial analysis was done for the association of stroke and MI with cardiometabolic risk factors (RF). Among RF, that were statistically significantly related to the complications studied, we selected only clinical RF. Each of those included was marked as a point: if it is present in this patient, than 1, if not, than 0. Then for each of 71602 patients with DM we calculated total points. For each point we calculated odds ratio (OR) for stroke and MI, 95% CI and statistical significance coefficient. The risk for stroke and MI significantly increased beginning at 5 points.
Conclusion. The proposed point system of the nearest risk of stroke and MI in DM patients is based upon the usage of clinical risk factors. Pointed riscometer is easy to use, available at any level of medical care, that will promote the concentration of efforts for target CVD levels achievement in DM patients.
About the Authors
N. V. Leonova
LLC “Anturium”
Russian Federation
Barnaul
Russian Federation
Barnaul
S. V. Pushkareva
Regional Clinical Hospital
Barnaul
Barnaul
References
1. Dedov II, Schestakova MV. Algorithms specialized medical care to patients with diabetes mellitus. М.; 2015:11-12, Russian (Дедов И.И., Шестакова М.В.. Алгоритмы специализированной медицинской помощи больным сахарным диабетом. М.; 2015:11-12).
2. Dedov II, Schestakova MV, Vikulova OK. The State Register of diabetes in the Russian Federation: the status of 2014 and prospects for development. Diabetes 2015; 18:5-23. Russian (Дедов И.И., Шестакова М.В., Викулова О.К.. Государственный регистр сахарного диабета в Российской Федерации: статус 2014 г. и перспективы развития. Сахарный диабет 2015, 18:5-23).
3. Perova NV, Metelskaya VA, Pokrovsky MC. New international systems determine overall risk of cardiovascular disease for use in clinical practice. М.; 2014. Russian (Перова Н.В., Метельская В.А., Покровский М.С. Новое в международных системах определения суммарного риска сердечно-сосудистых заболеваний для использования в клинической практике. М.; 2014).
4. Pushkareva SV, Chumakova GA, Leonova NV. Macroangiopathy association with cardio metabolic risk factors in patients of type 2 diabetes. SPb.; 2013:336 (Пушкарева С.В., Чумакова Г.А., Леонова Н.В. Ассоциация макроангиопатий с кардиометаболическими факторами риск у пациентов СД типа 2. // Материалы Российского национального конгресса кардиологов: Кардиология: от науки – к практике. СПб.; 2013:336).
5. Carnethon M, De Chavez P, Biggs M et al. Association of weight status with mortality in adults with incident diabetes. JAMA 2012; 308:581–90
6. Doehner W, Erdmann E, Cairns R, Clark A, Dormandy J, Ferrannini E, Anker S. Inverse relation of body weight and weight change with mortality and morbidity in patients with type 2 diabetes and cardiovascular co-morbidity: An analysis of the PROactive study population. International Journal of Cardiology 2012; 162:20–26
7. ESC/EAS Guidelines for the management of dyslipidaemias. The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Atherosclerosis 2011; 217S:S1–S44
8. European guidelines on cardiovascular disease prevention in clinical practice: executive summary. Fourth Joint Task Force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts). Eur J Cardiovasc Prev Rehabil 2007; 14:E1-40
9. Pencina M, D'Agostino R, Larson M, Massaro J, Vasan R. Predicting the 30-Year Risk of Cardiovascular Disease: The Framingham Heart Study, Circulation 2009; 119:3078-84
10. Stevens R, Kothari V, Adler A, Stratton I, Holman R. United Kingdom Prospective Diabetes Study (UKPDS) Group Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Radcliffe Infirmary, Woodstock Road, Oxford OX2 6HE, U.K. The UKPDS risk engine: a model for the risk of coronary heart disease in Type II diabetes (UKPDS 56). 2001. p.671-679
11. Tobias D, An Pan, Jackson C, O'Reilly E, Ding E, Willett W, Manson J, Hu F. Body-Mass Index and Mortality among Adults with Incident Type 2 Diabetes. N Engl J Med 2014; 370:233-44
12. World Health Organization. The World Health Report. 1999
Supplementary files
|
1. Неозаглавлен | |
| Subject | ||
| Type | Other | |
Download
(822KB)
|
Indexing metadata ▾ | |
Review
For citations:
Leonova N.V., Pushkareva S.V. SYSTEM FOR THE NEAREST CARDIOVASCULAR RISK ASSESSMENT IN SECOND TYPE DIABETES PATIENTS. Russian Journal of Cardiology. 2016;(4):30-34. (In Russ.) https://doi.org/10.15829/1560-4071-2016-4-30-34
Views:
953
Email this article 