Common carotid intima-media thickness does not add to Framingham risk score in individuals with diabetes mellitus: the USE-IMT initiative

被引：57

作者：

den Ruijter, H. M. ^{[1
,2
]}

Peters, S. A. E. ^{[1
]}

Groenewegen, K. A. ^{[1
]}

Anderson, T. J. ^{[3
,4
]}

Britton, A. R. ^{[5
]}

Dekker, J. M. ^{[6
]}

Engstrom, G. ^{[7
]}

Eijkemans, M. J. ^{[1
]}

Evans, G. W. ^{[8
]}

de Graaf, J. ^{[9
]}

Grobbee, D. E. ^{[1
,10
]}

Hedblad, B. ^{[7
]}

Hofman, A. ^{[11
]}

Holewijn, S. ^{[9
]}

Ikeda, A. ^{[12
]}

Kavousi, M. ^{[11
]}

Kitagawa, K. ^{[13
]}

Kitamura, A. ^{[12
]}

Koffijberg, H. ^{[1
]}

Ikram, M. A. ^{[11
,14
,15
]}

Lonn, E. M. ^{[16
,17
]}

Lorenz, M. W. ^{[18
]}

Mathiesen, E. B. ^{[19
]}

Nijpels, G. ^{[6
]}

Okazaki, S. ^{[13
]}

O'Leary, D. H. ^{[20
]}

Polak, J. F. ^{[20
]}

Price, J. F. ^{[21
]}

Robertson, C. ^{[21
]}

Rembold, C. M. ^{[22
]}

Rosvall, M. ^{[7
]}

Rundek, T. ^{[23
]}

Salonen, J. T. ^{[24
]}

Sitzer, M. ^{[18
,25
]}

Stehouwer, C. D. A. ^{[26
,27
]}

Witteman, J. C. ^{[11
]}

Moons, K. G. ^{[1
]}

Bots, M. L. ^{[1
]}

机构：

[1] Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, NL-3584 CX Utrecht, Netherlands

[2] Univ Med Ctr Utrecht, Dept Expt Cardiol, NL-3584 CX Utrecht, Netherlands

[3] Univ Calgary, Dept Cardiac Sci, Calgary, AB T2N 1N4, Canada

[4] Univ Calgary, Libin Cardiovasc Inst Alberta, Calgary, AB T2N 1N4, Canada

[5] UCL, Dept Epidemiol & Publ Hlth, London, England

[6] Vrije Univ Amsterdam Med Ctr, Inst Hlth & Care Res, Amsterdam, Netherlands

[7] Lund Univ, Dept Clin Sci Malmo, Skane Univ Hosp, Malmo, Sweden

[8] Wake Forest Sch Med, Dept Biostat Sci & Neurol, Winston Salem, NC USA

[9] Radboud Univ Nijmegen, Med Ctr, Dept Gen Internal Med, Div Vasc Med, NL-6525 ED Nijmegen, Netherlands

[10] Univ Malaya, Med Ctr, Kuala Lumpur, Malaysia

[11] Erasmus Univ, Dept Epidemiol, Med Ctr, Rotterdam, Netherlands

[12] Osaka Med Ctr Hlth Sci & Promot, Osaka, Japan

[13] Osaka Univ, Stroke Ctr, Dept Neurol, Grad Sch Med, Osaka, Japan

[14] Erasmus Univ, Med Ctr, Dept Radiol, Rotterdam, Netherlands

[15] Erasmus Univ, Med Ctr, Dept Neurol, Rotterdam, Netherlands

[16] McMaster Univ, Dept Med, Div Cardiol, Hamilton, ON, Canada

[17] McMaster Univ, Populat Hlth Res Inst, Hamilton, ON, Canada

[18] Goethe Univ Frankfurt, Dept Neurol, Univ Hosp, D-60054 Frankfurt, Germany

[19] Univ Tromso, Brain & Circulat Res Grp, Inst Clin Med, Tromso, Norway

[20] Tufts Med Ctr, Dept Radiol, Boston, MA USA

[21] Univ Edinburgh, Ctr Populat Hlth Sci, Edinburgh, Midlothian, Scotland

[22] Univ Virginia, Dept Internal Med, Div Cardiol, Charlottesville, VA USA

[23] Univ Miami, Miller Sch Med, Dept Neurol, Miami, FL 33136 USA

[24] MAS Metab Analyt Serv Oy, Helsinki, Finland

[25] Dept Neurol Klinikum, Herford, Germany

[26] Maastricht Univ, Med Ctr, Dept Internal Med, Maastricht, Netherlands

[27] Maastricht Univ, Med Ctr, Cardiovasc Res Inst Maastricht, Maastricht, Netherlands

来源：

DIABETOLOGIA | 2013年 / 56卷 / 07期

关键词：

Atherosclerosis; Cardiovascular disease; Carotid intima-media thickness; Diabetes; Prognosis; Risk prediction; ANKLE-BRACHIAL INDEX; CARDIOVASCULAR-DISEASE; METABOLIC SYNDROME; TASK-FORCE; PREDICTION; ATHEROSCLEROSIS; EVENTS; ASSOCIATION; PREVENTION; GUIDELINES;

D O I：

10.1007/s00125-013-2898-9

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The aim of this work was to investigate whether measurement of the mean common carotid intima-media thickness (CIMT) improves cardiovascular risk prediction in individuals with diabetes. We performed a subanalysis among 4,220 individuals with diabetes in a large ongoing individual participant data meta-analysis involving 56,194 subjects from 17 population-based cohorts worldwide. We first refitted the risk factors of the Framingham heart risk score on the individuals without previous cardiovascular disease (baseline model) and then expanded this model with the mean common CIMT (CIMT model). The absolute 10 year risk for developing a myocardial infarction or stroke was estimated from both models. In individuals with diabetes we compared discrimination and calibration of the two models. Reclassification of individuals with diabetes was based on allocation to another cardiovascular risk category when mean common CIMT was added. During a median follow-up of 8.7 years, 684 first-time cardiovascular events occurred among the population with diabetes. The C statistic was 0.67 for the Framingham model and 0.68 for the CIMT model. The absolute 10 year risk for developing a myocardial infarction or stroke was 16% in both models. There was no net reclassification improvement with the addition of mean common CIMT (1.7%; 95% CI -1.8, 3.8). There were no differences in the results between men and women. There is no improvement in risk prediction in individuals with diabetes when measurement of the mean common CIMT is added to the Framingham risk score. Therefore, this measurement is not recommended for improving individual cardiovascular risk stratification in individuals with diabetes.

引用

页码：1494 / 1502

页数：9

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