Risk for cardiovascular events in a local population of diabetic patients

Diabetes mellitus (DM) is a major risk factor for cardiovascular (CV) events. Many algorithms have been devised to assess CV risk, some of which specific for diabetics. Most of them, however, are based on data which can hardly be extrapolated to Mediterranean countries. AIM of the present study was to analyze CV risk and the incidence of CV events in a local cohort of patients with type 2 DM. METHODS. Clinical charts of two Diabetes Clinics of Modena in the period 1991-1994 were analyzed. Patients aged 35-65 with type 2 DM and no history of CV disease were eligible. Global CV risk was computed according to Framingham, RISCARD, Progetto Cuore and UKPDS algorithms and compared with the actual rate of CV events over the following 10 years. RESULTS. 774 patients were screened; 473 of them (61.1%) were eligible on the basis of predefined criteria and completeness of data. In such population an absolute 10-yr risk rate of 10.8% was observed. When comparing the estimated risk rate according to the different functions, a high degree of variability was present; Italian algorithms were more consistent with the observed data even if only 31% of patients with CV events had a risk > 20% at initial observation. CONCLUSIONS. Estimation of CV risk is largely dependent on the algorithm adopted and on the baseline risk of the reference cohort. Functions designed for a specific population should be adopted. The overall performance of such functions is however low. The algorithm derived from the present study will be utilized for a prospective evaluation of CV risk in our local cohort.