SCORE2-Diabetes correlated moderately with coronary calcium score (R=0.42) and predicted high atherosclerotic burden (C-statistic 0.73) and obstructive CAD (C-statistic 0.79).
Does the SCORE2-Diabetes risk model correlate with coronary atherosclerotic burden and identify high-risk patients better than the classic SCORE2 in individuals with type 2 diabetes?
The SCORE2-Diabetes risk model correlates moderately with coronary artery calcium score and effectively identifies diabetic patients with high atherosclerotic burden or obstructive CAD.
Absolute Event Rate: 0% vs 0%
Abstract Introduction Recently, the European Society of Cardiology developed a prediction model (SCORE2-Diabetes) to estimate the 10-year risk of cardiovascular disease (CVD) in individuals with type 2 diabetes, adding diabetes-related variables (i.e. age at diabetes diagnosis, glycated haemoglobin HbA1c and creatinine-based estimated glomerular filtration rate eGFR) to the conventional risk factors included in the SCORE2. While previous population-based studies have indicated a moderate predictive ability of this tool for CVD, its association with coronary atherosclerotic (CAS) burden remains unclear. This study aimed to analyse the relationship between SCORE-2 Diabetes and coronary artery calcium score (CACS) as an indicator of atherosclerotic burden. Methods Individuals 40-69 years with type 2 diabetes and without known CVD were identified from a single-center registry of patients undergoing CACS and coronary CT angiography for to suspected coronary artery disease (CAD). SCORE-2 Diabetes was categorized into risk groups according to the current European guidelines, and CACS was classified into four strata based on Agatston score ranges (0, 0-99, 100-299, or ≥ 300). We assessed the distribution of CACS across risk groups, the correlation between SCORE2-Diabetes and CACS, and the ability of SCORE2-Diabetes to identify patients with high atherosclerotic burden, defined as CACS ≥ 300. Additionally, we compared the performance of SCORE2-Diabetes against the classic SCORE2, intended for individuals without diabetes. Results A total of 149 patients (57% men, mean age 60±7 years) were included. The mean HbA1c, age of diagnosis of diabetes, and eGFR were 7.2±1.3%, 53±10 years and 98±32 mL/min/1.73 m2, respectively. The distribution of patients across risk categories was 3% at moderate risk, 36% at high risk, and 61% at very high risk. The median CACS was 49 (IQR 0-399 AU), with 31% (n=46) of patients having a CACS of 0 and 42% (n=63) presenting CACS values ≥ 100. The distribution of CACS across SCORE2-Diabetes-defined risk groups is presented in Figure 1A. SCORE-2 Diabetes showed a moderate correlation with CACS (Spearman’s R=0.42; p=0.001) and good discriminative ability to identify patients with CACS ≥ 300 (C-statistic of 0.73, 95% CI 0.66-0.81, p0.001). Moreover, SCORE-2 Diabetes also displayed a good predictive value to identify patients with obstructive CAD on coronary CT angiography (C-statistic 0.79, 95% CI 0.74-0.88, p0.001). Compared to SCORE2-Diabetes, the classic SCORE2 showed a numerically lower correlation with CACS (Spearman’s R 0.38, p=0.001) and also lower predictive value to identify patients with CACS ≥ 300 (C-statistic of 0.69, 95% CI 60-0.78, p0.001). Conclusion SCORE2-Diabetes seems to correlate moderately with CACS and have relatively good ability to identify patients with high atherosclerotic burden and/or obstructive CAD. These findings support the use of this new tool to assess cardiovascular risk in diabetic patients.
Pereira et al. (Sat,) reported a other. SCORE2-Diabetes correlated moderately with coronary calcium score (R=0.42) and predicted high atherosclerotic burden (C-statistic 0.73) and obstructive CAD (C-statistic 0.79).