Thus, in this article we examined the performance of the UKPDS Risk Engine (version 3) and the Framingham risk equations (2008) in estimating CVD incidence in three population subgroups: 1) individuals with known diabetes 2) individuals with nondiabetic hyperglycemia (A1C ≥6.0%) and 3) individuals with A1C <6.0% (normoglycemia).Įuropean Prospective Investigation of Cancer (EPIC)-Norfolk is a prospective cohort study in which men and women aged 40–79 years were recruited from general practices in the Norfolk region of the U.K. The CARDS trial cohort is not necessarily as widely generalizable as a true population-based sample. ![]() This novel risk equation has been validated in the Collaborative Atorvastatin Diabetes Study (CARDS) cohort ( 8), which was a primary prevention trial, and showed good predictive ability. In version 3, equations have been derived that estimate CVD risk directly ( 7). Version 2 of the Risk Engine estimates coronary heart disease risk and stroke risk separately. The UK Prospective Diabetes Study (UKPDS) Risk Engine is a type 2 diabetes-specific risk calculator that includes A1C as well as traditional CVD risk factors. ![]() However, although some studies have concluded that the Framingham risk equations for estimating CVD risk provide acceptable results when applied to populations outside North America ( 4), others have suggested that they are not applicable in those with a particularly low or high risk ( 5), including individuals with diabetes ( 6). Multivariate equations such as the Framingham equations are used to estimate CVD risk to target therapy to those with the highest absolute risk and to provide patients and practitioners with prognostic information. ![]() Multifactorial interventions aimed to reduce hyperglycemia, hypertension, and hypercholesterolemia are effective for reducing the risk of cardiovascular and microvascular events in diabetic individuals ( 2, 3). Individuals with type 2 diabetes have a two to four times increased risk of cardiovascular disease (CVD) compared with those without diabetes ( 1).
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