SCORE2-Diabetes: 10-year cardiovascular risk estimation in type 2 diabetes in Europe
European Heart Journal
Abstract
To develop and validate a recalibrated prediction model (SCORE2-Diabetes) to estimate the 10-year risk of cardiovascular disease (CVD) in individuals with type 2 diabetes in Europe.
SCORE2-Diabetes was developed by extending SCORE2 algorithms using individual-participant data from four large-scale datasets comprising 229 460 participants (43 706 CVD events) with type 2 diabetes and without previous CVD. Sex-specific competing risk-adjusted models were used including conventional risk factors (i.e. age, smoking, systolic blood pressure, total, and HDL-cholesterol), as well as diabetes-related variables (i.e. age at diabetes diagnosis, glycated haemoglobin [HbA1c] and creatinine-based estimated glomerular filtration rate [eGFR]). Models were recalibrated to CVD incidence in four European risk regions. External validation included 217 036 further individuals (38 602 CVD events), and showed good discrimination, and improvement over SCORE2 (C-index change from 0.009 to 0.031). Regional calibration was satisfactory. SCORE2-Diabetes risk predictions varied several-fold, depending on individuals’ levels of diabetes-related factors. For example, in the moderate-risk region, the estimated 10-year CVD risk was 11% for a 60-year-old man, non-smoker, with type 2 diabetes, average conventional risk factors, HbA1c of 50 mmol/mol, eGFR of 90 mL/min/1.73 m2, and age at diabetes diagnosis of 60 years. By contrast, the estimated risk was 17% in a similar man, with HbA1c of 70 mmol/mol, eGFR of 60 mL/min/1.73 m2, and age at diabetes diagnosis of 50 years. For a woman with the same characteristics, the risk was 8% and 13%, respectively.
SCORE2-Diabetes, a new algorithm developed, calibrated, and validated to predict 10-year risk of CVD in individuals with type 2 diabetes, enhances identification of individuals at higher risk of developing CVD across Europe.
Contributors
Lisa Pennells
Author
University of Cambridge Cambridge , United Kingdom of Great Britain & Northern Ireland
Stephen Kaptoge
Author
Helena Bleken Østergaard
Author
Stephanie H Read
Author
Fabrizio Carinci
Author
Josep Franch-Nadal
Author
Carmen Petitjean
Author
Owen Taylor
Author
Steven H J Hageman
Author
Zhe Xu
Author
Fanchao Shi
Author
Sarah Spackman
Author
Stefano Gualdi
Author
Naomi Holman
Author
Fabrice Bonnet
Author
Hermann Brenner
Author
Richard F Gillum
Author
Stefan Kiechl
Author
Deborah A Lawlor
Author
Louis Potier
Author
Ben Schöttker
Author
Reecha Sofat
Author
Henry Völzke
Author
Johann Willeit
Author
Zane Baltane
Author
Stephen Fava
Author
Sandor Janos
Author
Astrid Lavens
Author
Santa Pildava
Author
Tamara Poljicanin
Author
Ivan Pristas
Author
Reiff Sascha
Author
Christa Scheidt-Nave
Author
Iztok Stotl
Author
Gail Tibor
Author
Vilma Urbančič-Rovan
Author
An-Sofie Vanherwegen
Author
Dorte Vistisen
Author
Yong Du
Author
Matthew R Walker
Author
Peter Willeit
Author
Brian Ference
Author
Dirk De Bacquer
Author
Radu Huculeci
Author
John William McEvoy
Author
Adam Timmis
Author
Panagiotis Vardas
Author
Ian Graham
Author
Angela Wood
Author
Björn Eliasson
Author
William Herrington
Author
University of Oxford Oxford , United Kingdom of Great Britain & Northern Ireland
John Danesh
Author
Dídac Mauricio
Author
Massimo Massi Benedetti
Author
Naveed Sattar
Author
Frank L J Visseren
Author
Sarah Wild
Author
Emanuele Di Angelantonio
Author
University of Cambridge Cambridge , United Kingdom of Great Britain & Northern Ireland
Beverley Balkau
Author
Fabrice Bonnet
Author
Frederic Fumeron
Author
Hannah Stocker
Author
Bernd Holleczek
Author
Sabine Schipf
Author
Carsten Oliver Schmidt
Author
Marcus Dörr
Author
Herbert Tilg
Author
Christoph Leitner
Author
Marlene Notdurfter
Author
Julie Taylor
Author
Caroline Dale
Author
David Prieto-Merino
Author
Richard F Gillum
Author
Astrid Lavens
Author
An-Sofie Vanherwegen
Author
Tamara Poljicanin
Author
Ivan Pristas
Author
Tamara Buble
Author
Pero Ivanko
Author
Peter Rossing
Author
Bendix Carstensen
Author
Christin Heidemann
Author
Yong Du
Author
Christa Scheidt-Nave
Author
Tibor Gall
Author
Janos Sandor
Author
Zane Baltane
Author
Santa Pildava
Author
Jana Lepiksone
Author
Caroline J Magri
Author
Joseph Azzopardi
Author
Iztok Stotl
Author
Jordi Real
Author
Bogdan Vlacho
Author
Manel Mata-Cases
Author
