Journal of Lipid and Atherosclerosis (지질동맥경화학회지)

The Korean Society of Lipid and Atherosclerosis (한국지질동맥경화학회)
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Prediction of Coronary Heart Disease Risk in Korean Patients with Diabetes Mellitus

  • Koo, Bo Kyung (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Oh, Sohee (Department of Biostatistics, Seoul National University Boramae Medical Center) ;
  • Kim, Yoon Ji (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Moon, Min Kyong (Department of Internal Medicine, Seoul National University College of Medicine)
  • Received : 2018.11.26
  • Accepted : 2018.12.19
  • Published : 2018.12.31
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Abstract

Objective: We developed a new equation for predicting coronary heart disease (CHD) risk in Korean diabetic patients using a hospital-based cohort and compared it with a UK Prospective Diabetes Study (UKPDS) risk engine. Methods: By considering patients with type 2 diabetes aged ${\geq}30years$ visiting the diabetic center in Boramae hospital in 2006, we developed a multivariable equation for predicting CHD events using the Cox proportional hazard model. Those with CHD were excluded. The predictability of CHD events over 6 years was evaluated using area under the receiver operating characteristic (AUROC) curves, which were compared using the DeLong test. Results: A total of 732 participants (304 males and 428 females; mean age, $60{\pm}10years$; mean duration of diabetes, $10{\pm}7years$) were followed up for 76 months (range, 1-99 month). During the study period, 48 patients (6.6%) experienced CHD events. The AUROC of the proposed equation for predicting 6-year CHD events was 0.721 (95% confidence interval [CI], 0.641-0.800), which is significantly larger than that of the UKPDS risk engine (0.578; 95% CI, 0.482-0.675; p from DeLong test=0.001). Among the subjects with <5% of risk based on the proposed equation, 30.6% (121 out of 396) were classified as ${\geq}10%$ of risk based on the UKPDS risk engine, and their event rate was only 3.3% over 6 years. Conclusion: The UKPDS risk engine overestimated CHD risk in type 2 diabetic patients in this cohort, and the proposed equation has superior predictability for CHD risk compared to the UKPDS risk engine.

Keywords

References

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