Derivation and validation of a new cardiovascular risk score for people with type 2 diabetes: The New Zealand diabetes cohort study

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dc.contributor.author Elley, Carolyn en
dc.contributor.author Robinson, Elizabeth en
dc.contributor.author Kenealy, Timothy en
dc.contributor.author Bramley, D en
dc.contributor.author Drury, PL en
dc.date.accessioned 2012-03-06T21:13:32Z en
dc.date.issued 2010 en
dc.identifier.citation Diabetes Care 33(6):1347-1352 Jun 2010 en
dc.identifier.issn 0149-5992 en
dc.identifier.uri http://hdl.handle.net/2292/13140 en
dc.description.abstract OBJECTIVE--To derive a 5-year cardiovascular disease (CVD) risk equation from usual-care data that is appropriate for people with type 2 diabetes from a wide range of ethnic groups, variable glycemic control, and high rates of albuminuria in New Zealand. RESEARCH DESIGN AND METHODS--This prospective open-cohort study used primary-care data from 36,127 people with type 2 diabetes without previous CVD to derive a CVD equation using Cox proportional hazards regression models. Data from 12,626 people from a geographically different area were used for validation. Outcome measure was time to first fatal or nonfatal cardiovascular event, derived from national hospitalization and mortality records. Risk factors were age at diagnosis, diabetes duration, sex, systolic blood pressure, smoking status, total cholesterol-to-HDL ratio, ethnicity, glycated hemoglobin (A1C), and urine albumin-to-creatinine ratio. RESULTS--Baseline median age was 59 years, 51% were women, 55% were of non-European ethnicity, and 33% had micro- or macroalbuminuria. Median follow-up was 3.9 years (141,169 person-years), including 10,030 individuals followed for at least 5 years. At total of 6,479 first cardiovascular events occurred during follow-up. The 5-year observed risk was 20.8% (95% CI 20.3-21.3). Risk increased with each 1% A1C (adjusted hazard ratio 1.06 [95% CI 1.05-1.08]), when macroalbuminuria was present (2.04 [1.89-2.21]), and in Indo-Asians (1.29 [1.14-1.46]) and Maori (1.23 [1.14-1.32]) compared with Europeans. The derived risk equations performed well on the validation cohort compared with other risk equations. CONCLUSIONS--Renal function, ethnicity, and glycemic control contribute significantly to cardiovascular risk prediction. Population-appropriate risk equations can be derived from routinely collected data. en
dc.publisher Infotrac en
dc.relation.ispartofseries Diabetes Care en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. Details obtained from ttp://www.sherpa.ac.uk/romeo/issn/0149-5992/ en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.title Derivation and validation of a new cardiovascular risk score for people with type 2 diabetes: The New Zealand diabetes cohort study en
dc.type Journal Article en
dc.identifier.doi 10.2337/dc09-1444 en
pubs.issue 6 en
pubs.begin-page 1347 en
pubs.volume 33 en
dc.rights.holder Copyright: Infotrac en
dc.identifier.pmid 20299482 en
pubs.end-page 1352 en
dc.rights.accessrights http://purl.org/eprint/accessRights/RestrictedAccess en
pubs.subtype Article en
pubs.elements-id 187879 en
pubs.org-id Medical and Health Sciences en
pubs.org-id Population Health en
pubs.org-id Gen.Practice& Primary Hlthcare en
pubs.org-id School of Medicine en
pubs.org-id Medicine Department en
dc.identifier.eissn 1935-5548 en
pubs.record-created-at-source-date 2011-09-26 en
pubs.dimensions-id 20299482 en


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