Common carotid intima-media thickness does not add to Framingham risk score in individuals with diabetes mellitus: the USE-IMT initiative.

Pubmed ID: 23568273

Pubmed Central ID: PMC4523149

Journal: Diabetologia

Publication Date: July 1, 2013

MeSH Terms: Humans, Cardiovascular Diseases, Risk Factors, Stroke, Myocardial Infarction, Diabetes Mellitus, Carotid Intima-Media Thickness

Grants: HHSN268200800007C, HHSN268201200036C, N01 HC085085, N01HC55222, N01HC85079, N01HC85080, N01HC85081, N01HC85082, N01HC85083, N01HC85086, R01 AG023629, U01 HL080295, MR/K013351/1, PG/11/63/29011, RG/13/2/30098

Authors: Lorenz MW, Polak JF, Kavousi M, Mathiesen EB, Rundek T, Bots ML, Witteman JC, Hofman A, Sitzer M, Evans GW, Grobbee DE, Moons KG, Rosvall M, Dekker JM, Nijpels G, Stehouwer CD, Kitamura A, den Ruijter HM, Peters SA, Groenewegen KA, Anderson TJ, Britton AR, Engström G, Eijkemans MJ, de Graaf J, Hedblad B, Holewijn S, Ikeda A, Kitagawa K, Koffijberg H, Ikram MA, Lonn EM, Okazaki S, O'Leary DH, Price JF, Robertson C, Rembold CM, Salonen JT

Cite As: den Ruijter HM, Peters SA, Groenewegen KA, Anderson TJ, Britton AR, Dekker JM, Engström G, Eijkemans MJ, Evans GW, de Graaf J, Grobbee DE, Hedblad B, Hofman A, Holewijn S, Ikeda A, Kavousi M, Kitagawa K, Kitamura A, Koffijberg H, Ikram MA, Lonn EM, Lorenz MW, Mathiesen EB, Nijpels G, Okazaki S, O'Leary DH, Polak JF, Price JF, Robertson C, Rembold CM, Rosvall M, Rundek T, Salonen JT, Sitzer M, Stehouwer CD, Witteman JC, Moons KG, Bots ML. Common carotid intima-media thickness does not add to Framingham risk score in individuals with diabetes mellitus: the USE-IMT initiative. Diabetologia 2013 Jul;56(7):1494-502. Epub 2013 Apr 9.

Studies:

Abstract

AIMS/HYPOTHESIS: The aim of this work was to investigate whether measurement of the mean common carotid intima-media thickness (CIMT) improves cardiovascular risk prediction in individuals with diabetes. METHODS: We performed a subanalysis among 4,220 individuals with diabetes in a large ongoing individual participant data meta-analysis involving 56,194 subjects from 17 population-based cohorts worldwide. We first refitted the risk factors of the Framingham heart risk score on the individuals without previous cardiovascular disease (baseline model) and then expanded this model with the mean common CIMT (CIMT model). The absolute 10 year risk for developing a myocardial infarction or stroke was estimated from both models. In individuals with diabetes we compared discrimination and calibration of the two models. Reclassification of individuals with diabetes was based on allocation to another cardiovascular risk category when mean common CIMT was added. RESULTS: During a median follow-up of 8.7 years, 684 first-time cardiovascular events occurred among the population with diabetes. The C statistic was 0.67 for the Framingham model and 0.68 for the CIMT model. The absolute 10 year risk for developing a myocardial infarction or stroke was 16% in both models. There was no net reclassification improvement with the addition of mean common CIMT (1.7%; 95% CI -1.8, 3.8). There were no differences in the results between men and women. CONCLUSIONS/INTERPRETATION: There is no improvement in risk prediction in individuals with diabetes when measurement of the mean common CIMT is added to the Framingham risk score. Therefore, this measurement is not recommended for improving individual cardiovascular risk stratification in individuals with diabetes.