Ukpds 60

Kothari, Viti; Stevens, R J; Adler, Amanda I; Stratton, I M; Manley, Susan E.; Neil, H. A. W.; Holman, R. R.

doi:10.1161/01.str.0000020091.07144.c7

Cited by 381 publications

(141 citation statements)

References 59 publications

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“…The UKPDS risk engine has been developed for diabetic patients, for both coronary heart disease and for stroke [37,38]. Some of the subjects included in the UKPDS had a FPG of only 6 mmol/l at inclusion, so are comparable to the hyperglycaemic subjects in our study.…”

Section: Discussionmentioning

confidence: 94%

Prediction of the risk of cardiovascular mortality using a score that includes glucose as a risk factor. The DECODE Study

Balkau

Hu²,

Qiao³

et al. 2004

Diabetologia

139

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Aims/hypothesis. Risk scores have been developed to predict cardiovascular or coronary risk, and while most have included diabetes as a risk factor, none have included lower glucose concentrations, either at fasting or following a 2-h oral glucose tolerance test. This article develops 5-and 10-year risk scores for cardiovascular mortality that include glucose concentrations as well as known diabetes status. Methods. Data is from the DECODE cohort: 16,506 men and 8,907 women from 14 European studies. The risk factors studied were as follows: age, fasting and 2-h glucose (including cases of known diabetes), fasting glucose alone (including cases of known diabetes), cholesterol, smoking status, systolic blood pressure and BMI. For an absolute risk score the 1995 countryand sex-specific cardiovascular death rates were used. Results. In men, for both 5-and 10-year cardiovascular mortality, after adjusting for age and study centre, all studied risk factors, except BMI, were significantly associated with cardiovascular mortality (p<0.05). These results were unchanged in multivariate models with all factors included. In women, after adjusting for age and centre, glucose categories, systolic blood pressure and BMI were predictive of 5-year cardiovascular mortality. With all factors in the model, only age and glucose categories were predictive. In terms of 10-year cardiovascular mortality, smoking status and blood pressures were also predictive in the women. For men and women, the same scores were used for the risk factors, except for age and glucose categories where the hazard ratios differed significantly. Conclusions/interpretation. Including glucose concentrations as well as diabetic status provides quantitative information on cardiovascular risk prediction.

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Section: Discussionmentioning

confidence: 94%

Prediction of the risk of cardiovascular mortality using a score that includes glucose as a risk factor. The DECODE Study

Balkau

Hu²,

Qiao³

et al. 2004

Diabetologia

139

View full text Add to dashboard Cite

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“…The baseline characteristics of the ADVANCE trial participants were used to calculate the expected 4-year probability of CHD and cerebrovascular events using the UKPDS risk equations [9,11] and two different Framingham equations, namely Anderson et al [8] and D'Agostino et al [16]. In addition, the expected probability of total CVD was also derived from Framingham equations [8,16].…”

Section: Cardiovascular Risk Modelsmentioning

confidence: 99%

“…The Framingham Anderson equations have been recommended for risk estimation over a range of 4 to 12 years [8]. The UKPDS equations have been designed for risk evaluation for any duration of follow-up (t) in years in a patient who has been newly diagnosed with type 2 diabetes or who has had diabetes for a known duration of years (T) [9,11]. The Framingham D'Agostino equations were published with the 10-year baseline survival rates [16].…”

Section: Cardiovascular Risk Modelsmentioning

confidence: 99%

“…Risk prediction equations have also been developed specifically for individuals with diabetes [9,[11][12][13]. The best known are those of the UK Prospective Diabetes Study (UKPDS) [9,11].…”

Section: Introductionmentioning

confidence: 99%

“…The best known are those of the UK Prospective Diabetes Study (UKPDS) [9,11]. A particular feature of some of these models is that they consider glucose measurements and the duration of diagnosed diabetes.…”

Section: Introductionmentioning

confidence: 99%

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The Framingham and UK Prospective Diabetes Study (UKPDS) risk equations do not reliably estimate the probability of cardiovascular events in a large ethnically diverse sample of patients with diabetes: the Action in Diabetes and Vascular Disease: Preterax and Diamicron-MR Controlled Evaluation (ADVANCE) Study

et al. 2010

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Aims/hypothesis Available multivariable equations for cardiovascular risk assessment in people with diabetes have been derived either from the general population or from populations with diabetes. Their utility and comparative performance in a contemporary group of patients with type 2 diabetes are not well established. Diabetologia (2010) 53:821-831 DOI 10.1007/s00125-010-1681 Framingham and the UKPDS risk equations in 7,502 individuals with type 2 diabetes without prior known CVD at their enrolment in the trial. Results The risk of major CVD was overestimated by 170% (95% CI 146-195%) and 202% (176-231%) using the two Framingham equations. The risk of major coronary heart disease was overestimated by 198% (162-238%) with the UKPDS, and by 146% (117-179%) and 289% (243-341%) with the two different Framingham equations, respectively. The risks of stroke events were also overestimated with the UKPDS and one of the Framingham equations. The ability of these equations to rank risk among ADVANCE participants was modest, with c-statistics ranging from 0.57 to 0.71. Results stratified by sex, treatment allocation and ethnicity were broadly similar. Conclusions/interpretation Application of the Framingham and UKPDS risk equations to a contemporary treated group of patients with established type 2 diabetes is likely to substantially overestimate cardiovascular risk.

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