The PRECISE-DM risk score predicted the presence of obstructive coronary artery disease (C-statistic 0.680) and risk of MACCE (C-statistic 0.708) in asymptomatic patients with type 2 diabetes.
Observational (n=2,799)
Does the PRECISE-DM risk score accurately predict obstructive coronary artery disease and MACCE in asymptomatic patients with type 2 diabetes mellitus?
The PRECISE-DM risk score provides an easy-to-use tool with acceptable discrimination for predicting obstructive coronary artery disease and long-term MACCE in asymptomatic patients with type 2 diabetes.
Effect estimate: C-statistic 0.680 for OCAD; 0.708 for MACCE
BACKGROUND: Obstructive coronary artery disease (OCAD) is a significant predictor of adverse clinical events in asymptomatic patients with type 2 diabetes mellitus (T2DM). HYPOTHESIS: We sought to develop an easy-to-use risk scoring system to predict OCAD and long-term clinical outcome in asymptomatic patients with T2DM (PRECISE-DM). METHODS: A total of 2799 asymptomatic patients with T2DM and no prior coronary disease were consecutively enrolled. OCAD was defined as ≥50% coronary artery stenosis on coronary computed tomography angiography (CCTA). A new risk scoring system was developed in 933 patients undergoing CCTA (derivation cohort) and its performance to predict OCAD and major adverse cardiac and cerebrovascular event (MACCE) was compared with other risk estimates. The scoring system was externally validated in 1899 patients not undergoing CCTA (validation cohort). RESULTS: The PRECISE-DM scoring system was created using seven variables that were associated with increased risk of OCAD, with scores ranging from 0 to 9. The scoring system predicted presence of OCAD with a C-statistic of 0.680 and risk of MACCE with a C-statistic of 0.708. The UKPDS risk engine and the Framingham risk score showed unreliable performance in prediction of OCAD (C-statistics 0.531 and 0.577, respectively). Calcium score was highly predictive for OCAD (C-statistic 0.825) but showed only modest accuracy in predicting MACCE (C-statistic 0.675). In the external validation cohort, the PRECISE-DM score showed acceptable discrimination for prediction of MACCE (C-statistic 0.707). CONCLUSIONS: The PRECISE-DM scoring system accurately predicted presence of OCAD and risk of MACCE in asymptomatic patients with T2DM.
Choi et al. (Mon,) conducted a observational in Type 2 diabetes mellitus (n=2,799). PRECISE-DM risk score vs. UKPDS risk engine, Framingham risk score, and Calcium score was evaluated on Presence of obstructive coronary artery disease (OCAD) and major adverse cardiac and cerebrovascular event (MACCE) (C-statistic 0.680 for OCAD; 0.708 for MACCE). The PRECISE-DM risk score predicted the presence of obstructive coronary artery disease (C-statistic 0.680) and risk of MACCE (C-statistic 0.708) in asymptomatic patients with type 2 diabetes.
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