AustralieFrV1, Main, Exploration, bibRecord, 007478

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

Identifieur interne : 007478 ( Main/Exploration ); précédent : 007477; suivant : 007479

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

Auteurs : A. P. Kengne [Australie] ; A. Patel [Australie] ; S. Colagiuri [Australie] ; S. Heller [Royaume-Uni] ; P. Hamet [Canada] ; M. Marre [France] ; C. Y. Pan [République populaire de Chine] ; S. Zoungas [Australie] ; D. E. Grobbee [Pays-Bas] ; B. Neal [Australie] ; J. Chalmers [Australie] ; M. Woodward [Australie, États-Unis]

Source :

Diabetologia : (Berlin) [ 0012-186X ] ; 2010.

RBID : Pascal:10-0239448

Descripteurs français

Pascal (Inist)
- Prospective, Facteur risque, Pathologie des vaisseaux sanguins, Evaluation, Pathologie de l'appareil circulatoire, Discrimination, Diabète, Prédiction, Homme.
Wicri :
- topic : Prospective, Diabète, Homme.

English descriptors

KwdEn :
- Cardiovascular disease, Diabetes mellitus, Discrimination, Evaluation, Human, Prediction, Prospective, Risk factor, Vascular disease.

Abstract

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. The aim of this study was to evaluate the performance of the Framingham and UK Prospective Diabetes Study (UKPDS) risk equations in participants who took part in the Action in Diabetes and Vascular disease: Preterax and Diamicron-MR Controlled Evaluation (ADVANCE) trial. Methods The 4-year risks of cardiovascular disease (CVD) and its constituents were estimated using two published 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.

Affiliations:

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Le document en format XML

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<sZ>12 aut.</sZ>
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<country>Australie</country>
<wicri:noRegion>Sydney, NSW 2050</wicri:noRegion>
<orgName type="university">Université de Sydney</orgName>
<placeName><settlement type="city">Sydney</settlement>
<region type="état">Nouvelle-Galles du Sud</region>
</placeName>
</affiliation>
<affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Mount Sinai School of Medicine</s1>
<s2>New York, NY</s2>
<s3>USA</s3>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Mount Sinai School of Medicine</wicri:noRegion>
</affiliation>
</author>
</analytic>
<series><title level="j" type="main">Diabetologia : (Berlin)</title>
<title level="j" type="abbreviated">Diabetologia : (Berl.)</title>
<idno type="ISSN">0012-186X</idno>
<imprint><date when="2010">2010</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt><title level="j" type="main">Diabetologia : (Berlin)</title>
<title level="j" type="abbreviated">Diabetologia : (Berl.)</title>
<idno type="ISSN">0012-186X</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Cardiovascular disease</term>
<term>Diabetes mellitus</term>
<term>Discrimination</term>
<term>Evaluation</term>
<term>Human</term>
<term>Prediction</term>
<term>Prospective</term>
<term>Risk factor</term>
<term>Vascular disease</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Prospective</term>
<term>Facteur risque</term>
<term>Pathologie des vaisseaux sanguins</term>
<term>Evaluation</term>
<term>Pathologie de l'appareil circulatoire</term>
<term>Discrimination</term>
<term>Diabète</term>
<term>Prédiction</term>
<term>Homme</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Prospective</term>
<term>Diabète</term>
<term>Homme</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">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. The aim of this study was to evaluate the performance of the Framingham and UK Prospective Diabetes Study (UKPDS) risk equations in participants who took part in the Action in Diabetes and Vascular disease: Preterax and Diamicron-MR Controlled Evaluation (ADVANCE) trial. Methods The 4-year risks of cardiovascular disease (CVD) and its constituents were estimated using two published 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.</div>
</front>
</TEI>
<affiliations><list><country><li>Australie</li>
<li>Canada</li>
<li>France</li>
<li>Pays-Bas</li>
<li>Royaume-Uni</li>
<li>République populaire de Chine</li>
<li>États-Unis</li>
</country>
<region><li>Nouvelle-Galles du Sud</li>
<li>Utrecht (province)</li>
<li>Île-de-France</li>
</region>
<settlement><li>Paris</li>
<li>Pékin</li>
<li>Sydney</li>
<li>Utrecht</li>
</settlement>
<orgName><li>Université de Sydney</li>
</orgName>
</list>
<tree><country name="Australie"><region name="Nouvelle-Galles du Sud"><name sortKey="Kengne, A P" sort="Kengne, A P" uniqKey="Kengne A" first="A. P." last="Kengne">A. P. Kengne</name>
</region>
<name sortKey="Chalmers, J" sort="Chalmers, J" uniqKey="Chalmers J" first="J." last="Chalmers">J. Chalmers</name>
<name sortKey="Colagiuri, S" sort="Colagiuri, S" uniqKey="Colagiuri S" first="S." last="Colagiuri">S. Colagiuri</name>
<name sortKey="Neal, B" sort="Neal, B" uniqKey="Neal B" first="B." last="Neal">B. Neal</name>
<name sortKey="Patel, A" sort="Patel, A" uniqKey="Patel A" first="A." last="Patel">A. Patel</name>
<name sortKey="Woodward, M" sort="Woodward, M" uniqKey="Woodward M" first="M." last="Woodward">M. Woodward</name>
<name sortKey="Zoungas, S" sort="Zoungas, S" uniqKey="Zoungas S" first="S." last="Zoungas">S. Zoungas</name>
<name sortKey="Zoungas, S" sort="Zoungas, S" uniqKey="Zoungas S" first="S." last="Zoungas">S. Zoungas</name>
</country>
<country name="Royaume-Uni"><noRegion><name sortKey="Heller, S" sort="Heller, S" uniqKey="Heller S" first="S." last="Heller">S. Heller</name>
</noRegion>
</country>
<country name="Canada"><noRegion><name sortKey="Hamet, P" sort="Hamet, P" uniqKey="Hamet P" first="P." last="Hamet">P. Hamet</name>
</noRegion>
</country>
<country name="France"><region name="Île-de-France"><name sortKey="Marre, M" sort="Marre, M" uniqKey="Marre M" first="M." last="Marre">M. Marre</name>
</region>
</country>
<country name="République populaire de Chine"><noRegion><name sortKey="Pan, C Y" sort="Pan, C Y" uniqKey="Pan C" first="C. Y." last="Pan">C. Y. Pan</name>
</noRegion>
</country>
<country name="Pays-Bas"><region name="Utrecht (province)"><name sortKey="Grobbee, D E" sort="Grobbee, D E" uniqKey="Grobbee D" first="D. E." last="Grobbee">D. E. Grobbee</name>
</region>
</country>
<country name="États-Unis"><noRegion><name sortKey="Woodward, M" sort="Woodward, M" uniqKey="Woodward M" first="M." last="Woodward">M. Woodward</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>

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   |texte=   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
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