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

Abstract

Abstract 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.

Keywords

• Cardio‐ankle vascular index
• Diabetes mellitus
• Systematic Coronary Risk Evaluation 2‐Diabetes risk