Cardiovascular Risk Prediction Scores in Type 1 Diabetes
Background: The extent of the performance and utility of scores for the risk of cardiovascular disease (CVD) in persons with type 1 diabetes (T1DM) largely remains unclear. Objective: The purpose of this study was to synthesize data on the performance of CVD risk scores in people living with T1DM. M...
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Elsevier
2025-01-01
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| Series: | JACC: Advances |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772963X24007427 |
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| author | Sebhat Erqou, MD, PhD Ahmed Shahab, MD Fayez H. Fayad, MD Mohammed Haji, MD Matthew F. Yuyun, MD, PhD Jacob Joseph, MD Wen-Chih Wu, MD, MPH Amanda I. Adler, MD, PhD Trevor J. Orchard, MD, PhD Justin B. Echouffo-Tcheugui, MD, PhD |
| author_facet | Sebhat Erqou, MD, PhD Ahmed Shahab, MD Fayez H. Fayad, MD Mohammed Haji, MD Matthew F. Yuyun, MD, PhD Jacob Joseph, MD Wen-Chih Wu, MD, MPH Amanda I. Adler, MD, PhD Trevor J. Orchard, MD, PhD Justin B. Echouffo-Tcheugui, MD, PhD |
| author_sort | Sebhat Erqou, MD, PhD |
| collection | DOAJ |
| description | Background: The extent of the performance and utility of scores for the risk of cardiovascular disease (CVD) in persons with type 1 diabetes (T1DM) largely remains unclear. Objective: The purpose of this study was to synthesize data on the performance of CVD risk scores in people living with T1DM. Methods: This study is a systematic review and meta-analysis. PubMed and EMBASE were searched through December 31, 2023. The included studies: 1) were retrospective, prospective, or cross-sectional in design; 2) included persons with T1DM; 3) assessed CVD outcomes; and 4) had data on at least on CVD risk score. Measures of calibration and discrimination qualitatively summarized. Measures of discrimination were combined using random-effects models stratified by type of risk model. Results: In a meta-analysis of observational studies of CVD risk scores in T1DM individuals, including 11 studies and 73,664 participants (mean age of 34 years, mainly White individuals and male [55%]), we evaluated 12 CVD risk prediction models (7 T1DM-specific, 1 type 2 diabetes–specific, and 4 general population models). Most risk scores had a moderate to excellent discrimination (C-statistic: 0.73-0.85) and predicted CVD risk well when compared to actual clinical events. CVD risk scores specifically developed in T1DM individuals exhibited a higher discriminative performance—pooled C-statistic of 0.81 vs 0.75 for risk scores developed in the general population or those with type 2 diabetes and also showed a better calibration. Conclusions: Among individuals with T1DM, CVD risk models had a moderate to excellent discrimination, with a better discrimination and accuracy for T1DM-specific scores. |
| format | Article |
| id | doaj-art-099ff4c720ef4666a231cf49e6dc174f |
| institution | OA Journals |
| issn | 2772-963X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JACC: Advances |
| spelling | doaj-art-099ff4c720ef4666a231cf49e6dc174f2025-08-20T02:36:58ZengElsevierJACC: Advances2772-963X2025-01-014110146210.1016/j.jacadv.2024.101462Cardiovascular Risk Prediction Scores in Type 1 DiabetesSebhat Erqou, MD, PhD0Ahmed Shahab, MD1Fayez H. Fayad, MD2Mohammed Haji, MD3Matthew F. Yuyun, MD, PhD4Jacob Joseph, MD5Wen-Chih Wu, MD, MPH6Amanda I. Adler, MD, PhD7Trevor J. Orchard, MD, PhD8Justin B. Echouffo-Tcheugui, MD, PhD9Department of Medicine, Alpert Medical School of Brown University, Providence, Rhode Island, USA; Division of Cardiology, Department of Medicine, Providence VA Medical Center and Alpert Medical School of Brown University, Providence, Rhode Island, USADepartment of Medicine, Alpert Medical School of Brown University, Providence, Rhode Island, USADepartment of Medicine, Alpert Medical School of Brown University, Providence, Rhode Island, USADepartment of Medicine, Alpert Medical School of Brown University, Providence, Rhode Island, USADepartment of Medicine, VA Boston Healthcare System, Boston, USA; Department of Medicine, Harvard Medical School, Boston, USADepartment of Medicine, Alpert Medical School of Brown University, Providence, Rhode Island, USA; Division of Cardiology, Department of Medicine, Providence VA Medical Center and Alpert Medical School of Brown University, Providence, Rhode Island, USADepartment of Medicine, Alpert Medical School of Brown University, Providence, Rhode Island, USA; Division of Cardiology, Department of Medicine, Providence VA Medical Center and Alpert Medical School of Brown University, Providence, Rhode Island, USADiabetes Trials Unit, University of Oxford, Oxford, UKDepartment of Epidemiology, University of Pittsburgh, School of Public Health, Pittsburgh, Pennsylvania, USADivision of Diabetes, Department of Medicine, Endocrinology and Metabolism, Johns Hopkins University, Baltimore, Maryland, USA; Welch Prevention Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA; Address for correspondence: Dr Justin B. Echouffo-Tcheugui, Johns Hopkins University School of Medicine, 5501 Hopkins Bayview Circle, Baltimore, Maryland 21224, USA.Background: The extent of the performance and utility of scores for the risk of cardiovascular disease (CVD) in persons with type 1 diabetes (T1DM) largely remains unclear. Objective: The purpose of this study was to synthesize data on the performance of CVD risk scores in people living with T1DM. Methods: This study is a systematic review and meta-analysis. PubMed and EMBASE were searched through December 31, 2023. The included studies: 1) were retrospective, prospective, or cross-sectional in design; 2) included persons with T1DM; 3) assessed CVD outcomes; and 4) had data on at least on CVD risk score. Measures of calibration and discrimination qualitatively summarized. Measures of discrimination were combined using random-effects models stratified by type of risk model. Results: In a meta-analysis of observational studies of CVD risk scores in T1DM individuals, including 11 studies and 73,664 participants (mean age of 34 years, mainly White individuals and male [55%]), we evaluated 12 CVD risk prediction models (7 T1DM-specific, 1 type 2 diabetes–specific, and 4 general population models). Most risk scores had a moderate to excellent discrimination (C-statistic: 0.73-0.85) and predicted CVD risk well when compared to actual clinical events. CVD risk scores specifically developed in T1DM individuals exhibited a higher discriminative performance—pooled C-statistic of 0.81 vs 0.75 for risk scores developed in the general population or those with type 2 diabetes and also showed a better calibration. Conclusions: Among individuals with T1DM, CVD risk models had a moderate to excellent discrimination, with a better discrimination and accuracy for T1DM-specific scores.http://www.sciencedirect.com/science/article/pii/S2772963X24007427cardiovascular riskepidemiologyrisk predictionrisk scorestype 1 diabetes |
| spellingShingle | Sebhat Erqou, MD, PhD Ahmed Shahab, MD Fayez H. Fayad, MD Mohammed Haji, MD Matthew F. Yuyun, MD, PhD Jacob Joseph, MD Wen-Chih Wu, MD, MPH Amanda I. Adler, MD, PhD Trevor J. Orchard, MD, PhD Justin B. Echouffo-Tcheugui, MD, PhD Cardiovascular Risk Prediction Scores in Type 1 Diabetes JACC: Advances cardiovascular risk epidemiology risk prediction risk scores type 1 diabetes |
| title | Cardiovascular Risk Prediction Scores in Type 1 Diabetes |
| title_full | Cardiovascular Risk Prediction Scores in Type 1 Diabetes |
| title_fullStr | Cardiovascular Risk Prediction Scores in Type 1 Diabetes |
| title_full_unstemmed | Cardiovascular Risk Prediction Scores in Type 1 Diabetes |
| title_short | Cardiovascular Risk Prediction Scores in Type 1 Diabetes |
| title_sort | cardiovascular risk prediction scores in type 1 diabetes |
| topic | cardiovascular risk epidemiology risk prediction risk scores type 1 diabetes |
| url | http://www.sciencedirect.com/science/article/pii/S2772963X24007427 |
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