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The co-predictive value of a cardiovascular score for CV outcomes in diabetic patients with no atrial fibrillation

Patti, Giuseppe; Sticchi, Alessandro; Pasceri, Vincenzo; Ricci, Fabrizio LU ; Renda, Giulia; Hamrefors, Viktor LU ; Melander, Olle LU ; Sutton, Richard; Engström, Gunnar LU and De Caterina, Raffaele, et al. (2019) In Diabetes/Metabolism Research and Reviews p.1-9
Abstract
Background
Risk factors included in the cardiovascular (CHA2DS2‐VASc) score, currently used for atrial fibrillation (AF), may predispose to cardiovascular events whether or not AF is present. The aim was to explore the predictive role of CHA2DS2‐VASc score on cardiovascular outcomes in diabetic patients without AF.
Methods
We accessed individual data from 610 diabetic patients without AF at baseline included in the prospective cohort of the Malmö Diet and Cancer study. Main outcome measure was the occurrence of cardiovascular events (stroke, coronary events) and death. Mean follow‐up was 14.5 ± 5 years (8845 person/years).
Results
The CHA2DS2‐VASc score significantly predicted the risk of all outcome measures. There was... (More)
Background
Risk factors included in the cardiovascular (CHA2DS2‐VASc) score, currently used for atrial fibrillation (AF), may predispose to cardiovascular events whether or not AF is present. The aim was to explore the predictive role of CHA2DS2‐VASc score on cardiovascular outcomes in diabetic patients without AF.
Methods
We accessed individual data from 610 diabetic patients without AF at baseline included in the prospective cohort of the Malmö Diet and Cancer study. Main outcome measure was the occurrence of cardiovascular events (stroke, coronary events) and death. Mean follow‐up was 14.5 ± 5 years (8845 person/years).
Results
The CHA2DS2‐VASc score significantly predicted the risk of all outcome measures. There was a significant increase in stroke, coronary events, and death risk by each point of CHA2DS2‐VASc score elevation [stroke: adjusted hazard ratio (aHR) 1.43, 95% CI 1.14‐1.79, P = 0.001; coronary events: aHR 1.55, 95% CI 1.34‐1.80, P < 0.0001; death: aHR 1.94, 95% CI 1.71‐2.21, P < 0.0001]. A CHA2DS2‐VASc score ≥4 was associated with higher incidence of ischemic stroke (aHR 1.47, 95% CI 1.18‐1.82; P = 0.001), coronary events (aHR 1.32; 95% CI 1.11‐1.58; P = 0.002), and death (aHR 1.36; 95% CI 1.20‐1.54; P < 0.001).
Conclusions
In this population‐based study on diabetic patients without AF, the CHA2DS2‐VASc score was an independent predictor of ischemic stroke, coronary events, and overall mortality. Regardless of the AF status, the CHA2DS2‐VASc score might represent a rapid and user‐friendly tool for clinical assessment of diabetic patients at higher cardiovascular risk. (Less)
Please use this url to cite or link to this publication:
@article{22a651eb-afa8-4d12-8e04-8650bec778db,
  abstract     = {Background<br>
Risk factors included in the cardiovascular (CHA2DS2‐VASc) score, currently used for atrial fibrillation (AF), may predispose to cardiovascular events whether or not AF is present. The aim was to explore the predictive role of CHA2DS2‐VASc score on cardiovascular outcomes in diabetic patients without AF.<br>
Methods<br>
We accessed individual data from 610 diabetic patients without AF at baseline included in the prospective cohort of the Malmö Diet and Cancer study. Main outcome measure was the occurrence of cardiovascular events (stroke, coronary events) and death. Mean follow‐up was 14.5 ± 5 years (8845 person/years).<br>
Results<br>
The CHA2DS2‐VASc score significantly predicted the risk of all outcome measures. There was a significant increase in stroke, coronary events, and death risk by each point of CHA2DS2‐VASc score elevation [stroke: adjusted hazard ratio (aHR) 1.43, 95% CI 1.14‐1.79, P = 0.001; coronary events: aHR 1.55, 95% CI 1.34‐1.80, P &lt; 0.0001; death: aHR 1.94, 95% CI 1.71‐2.21, P &lt; 0.0001]. A CHA2DS2‐VASc score ≥4 was associated with higher incidence of ischemic stroke (aHR 1.47, 95% CI 1.18‐1.82; P = 0.001), coronary events (aHR 1.32; 95% CI 1.11‐1.58; P = 0.002), and death (aHR 1.36; 95% CI 1.20‐1.54; P &lt; 0.001).<br>
Conclusions<br>
In this population‐based study on diabetic patients without AF, the CHA2DS2‐VASc score was an independent predictor of ischemic stroke, coronary events, and overall mortality. Regardless of the AF status, the CHA2DS2‐VASc score might represent a rapid and user‐friendly tool for clinical assessment of diabetic patients at higher cardiovascular risk.},
  author       = {Patti, Giuseppe and  Sticchi, Alessandro and  Pasceri, Vincenzo and Ricci, Fabrizio and Renda, Giulia and Hamrefors, Viktor and Melander, Olle and Sutton, Richard and Engström, Gunnar and De Caterina, Raffaele and Fedorowski, Artur},
  issn         = {1520-7560},
  language     = {eng},
  month        = {02},
  pages        = {1--9},
  publisher    = {John Wiley & Sons},
  series       = {Diabetes/Metabolism Research and Reviews},
  title        = {The co-predictive value of a cardiovascular score for CV outcomes in diabetic patients with no atrial fibrillation},
  url          = {http://dx.doi.org/10.1002/dmrr.3145},
  year         = {2019},
}