Björn Zethelius1, Björn Eliasson2, Katarina Eeg-Olofsson2, Ann-Marie Svensson3, Soffia Gudbjörnsdottir4, Jan Cederholm5. 1. Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden; Medical Products Agency, Section for Epidemiology, Uppsala, Sweden. Electronic address: bjorn.zethelius@pubcare.uu.se. 2. Department of Medicine, Sahlgrenska University Hospital, Gothenburgh University, Göteborg, Sweden. 3. Center of Registers in Region Västra Götaland, Göteborg, Sweden. 4. Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden; Medical Products Agency, Section for Epidemiology, Uppsala, Sweden. 5. Department of Public Health and Caring Sciences/Family Medicine and Clinical Epidemiology, Uppsala University, Uppsala, Sweden.
Abstract
AIM: We assessed the association between risk factors and cardiovascular disease (CVD) in an observational study of type 2 diabetes patients from the Swedish National Diabetes Register. METHODS: A derivation sample of 24,288 patients, aged 30-74 years, 15.3% with previous CVD, baseline 2002, 2488 CVD events when followed for 5 years until 2007. A separate validation data set of 4906 patients, baseline 2003, 522 CVD events when followed for 4 years. RESULTS: Adjusted hazard ratios at Cox regression for fatal/nonfatal CVD were: onset-age 1.59, diabetes duration 1.55, total-cholesterol-to-HDL-cholesterol ratio 1.20, HbA1c 1.12, systolic BP 1.09, BMI 1.07 (1 SD increase in natural log continuous variables); males 1.41, smoker 1.35, microalbuminuria 1.27, macroalbuminuria 1.53, atrial fibrillation 1.50, previous CVD 1.98 (all p<0.001 except BMI p=0.0018). All 12 variables were used to elaborate an equation for 5-year CVD risk in the derivation dataset: mean 5-year risk 11.9±8.4%. Calibration in the validation dataset was adequate: ratio predicted 4-year risk/observed rate 0.97. Discrimination was sufficient: C statistic 0.72, sensitivity 51% and specificity 78% for top quartile. CONCLUSION: This CVD risk model from a large observational study of patients in routine care showed adequate calibration and discrimination, and can be useful for clinical practice.
AIM: We assessed the association between risk factors and cardiovascular disease (CVD) in an observational study of type 2 diabetespatients from the Swedish National Diabetes Register. METHODS: A derivation sample of 24,288 patients, aged 30-74 years, 15.3% with previous CVD, baseline 2002, 2488 CVD events when followed for 5 years until 2007. A separate validation data set of 4906 patients, baseline 2003, 522 CVD events when followed for 4 years. RESULTS: Adjusted hazard ratios at Cox regression for fatal/nonfatal CVD were: onset-age 1.59, diabetes duration 1.55, total-cholesterol-to-HDL-cholesterol ratio 1.20, HbA1c 1.12, systolic BP 1.09, BMI 1.07 (1 SD increase in natural log continuous variables); males 1.41, smoker 1.35, microalbuminuria 1.27, macroalbuminuria 1.53, atrial fibrillation 1.50, previous CVD 1.98 (all p<0.001 except BMI p=0.0018). All 12 variables were used to elaborate an equation for 5-year CVD risk in the derivation dataset: mean 5-year risk 11.9±8.4%. Calibration in the validation dataset was adequate: ratio predicted 4-year risk/observed rate 0.97. Discrimination was sufficient: C statistic 0.72, sensitivity 51% and specificity 78% for top quartile. CONCLUSION: This CVD risk model from a large observational study of patients in routine care showed adequate calibration and discrimination, and can be useful for clinical practice.
Authors: Björn Zethelius; Soffia Gudbjörnsdottir; Björn Eliasson; Katarina Eeg-Olofsson; Ann-Marie Svensson; Jan Cederholm Journal: Diabetologia Date: 2015-06-19 Impact factor: 10.122
Authors: Aliasghar Ahmad Kiadaliri; Ulf-G Gerdtham; Peter Nilsson; Björn Eliasson; Soffia Gudbjörnsdottir; Katarina Steen Carlsson Journal: PLoS One Date: 2013-05-09 Impact factor: 3.240
Authors: Nils Ekström; Jan Cederholm; Björn Zethelius; Björn Eliasson; Eva Fhärm; Olov Rolandsson; Mervete Miftaraj; Ann-Marie Svensson; Soffia Gudbjörnsdottir Journal: BMJ Open Date: 2013-04-20 Impact factor: 2.692
Authors: Aliasghar Ahmad Kiadaliri; Philip M Clarke; Ulf-G Gerdtham; Peter Nilsson; Björn Eliasson; Soffia Gudbjörnsdottir; Katarina Steen Carlsson Journal: J Diabetes Res Date: 2013-02-28 Impact factor: 4.011
Authors: David Preiss; Laine E Thomas; Jie-Lena Sun; Steven M Haffner; Rury R Holman; Eberhard Standl; Lawrence A Leiter; Theodore Mazzone; Guy E Rutten; Gianni Tognoni; Felipe A Martinez; Fu-Tien Chiang; Robert M Califf; John J McMurray Journal: BMJ Open Date: 2012-11-30 Impact factor: 2.692