Online Program

Development and validation prediction models for risks of coronary artery disease in patients with type 2diabetes

Tuesday, November 3, 2015

Hsiang-Chi Wang, Graduate institute of biostatistics, China Medical University, Taichung, Taiwan
Cheng-Chieh Lin, School of Medicine, China Medical University, Taichung, Taiwan
Tsai-Chung Li, Ph.D., Department of Public Health, China Medical University, Taichung, Taiwan
Prior studies established risk score prediction models for coronary artery disease of patients with type 2 diabetes in Western ethnicity, but few in Asian population. The aim of the study is to develop a prediction model for coronary artery disease by considering the variation of fasting blood glucose, and traditional risk factors in Chinese patients with type 2 diabetes from the database of Taiwan National Diabetes Care Management Program. A total of 27,756 patients aged 30-84 years were randomly allocated into derivation and validation sets with a ratio of 2:1. During a mean follow-up of 7.7 years, 25.51% of patients developed CAD in the derivation set. In validation set, 25.01% of patients developed CAD during a mean 7.8 years of follow-up. Cox model was used to determine risk scores of CAD. Calibration was assessed using by Hosmer-Lemeshow test, and discrimination ability was examined by the areas under receiver operating curve (AUROCs). This study found age, gender, smoking, alcohol drinking, obesity, blood pressure, high-density lipoprotein, HbA1c, total cholesterol, triglyceride, variation of fasting blood glucose, hypertension, diabetes retinopathy, anti-diabetes medications, cardiovascular medications and statins were significantly associated with CAD. The risk score ranged from -10 to 62. Calibration was excellent in two sets (P=0.13 and 0.91). The AUROCs of 5-year CAD risk was 0.631 in the derivation set, and was 0.643 in the validation set. In conclusion, this risk score model can be used by the clinicians to stratify Chinese patients with type 2 diabetes into groups at varying risk of CAD.

Learning Areas:

Basic medical science applied in public health
Biostatistics, economics
Chronic disease management and prevention
Protection of the public in relation to communicable diseases including prevention or control
Public health or related education

Learning Objectives:
Analyze the risk factors for coronary artery disease in patients with type 2 diabetes.

Keyword(s): Diabetes, Heart Disease

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I'm a graduate student from China Medical University. My major is biostatistics. Now I focusing on the risk score models for patients with type 2 diabetes.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.