Development and validation of a risk score for hospitalization for heart failure in patients with Type 2 Diabetes Mellitus

Xilin Yang; Ma, Ronald C.; Wing-Yee So; Kong, Alice P.; Ko, Gary T.; Chun-Shun Ho; Lam, Christopher W.; Cockram, Clive S.; Tong, Peter C.; Chan, Juliana C.
January 2008
Cardiovascular Diabetology;2008, Vol. 7, p1
Academic Journal
Background: There are no risk scores available for predicting heart failure in Type 2 diabetes mellitus (T2DM). Based on the Hong Kong Diabetes Registry, this study aimed to develop and validate a risk score for predicting heart failure that needs hospitalisation in T2DM. Methods: 7067 Hong Kong Chinese diabetes patients without history of heart failure, and without history and clinical evidence of coronary heart disease at baseline were analyzed. The subjects have been followed up for a median period of 5.5 years. Data were randomly and evenly assigned to a training dataset and a test dataset. Sex-stratified Cox proportional hazard regression was used to obtain predictors of HF-related hospitalization in the training dataset. Calibration was assessed using Hosmer-Lemeshow test and discrimination was examined using the area under receiver's operating characteristic curve (aROC) in the test dataset. Results: During the follow-up, 274 patients developed heart failure event/s that needed hospitalisation. Age, body mass index (BMI), spot urinary albumin to creatinine ratio (ACR), HbA1c, blood haemoglobin (Hb) at baseline and coronary heart disease during follow-up were predictors of HF-related hospitalization in the training dataset. HF-related hospitalization risk score = 0.0709 � age (year) + 0.0627 � BMI (kg/m�) + 0.1363 � HbA1c(%) + 0.9915 � Log10(1+ACR) (mg/mmol) - 0.3606 � Blood Hb(g/dL) + 0.8161 � CHD during follow-up (1 if yes). The 5-year probability of heart failure = 1-S0(5)EXP{0.9744 � (Risk Score - 2.3961)}. Where S0(5) = 0.9888 if male and 0.9809 if female. The predicted and observed 5-year probabilities of HF-related hospitalization were similar (p > 0.20) and the adjusted aROC was 0.920 for 5 years of follow-up. Conclusion: The risk score had adequate performance. Further validations in other cohorts of patients with T2DM are needed before clinical use.


Related Articles

  • Impact of left ventricular longitudinal diastolic functional reserve on clinical outcome in patients with type 2 diabetes mellitus. Sung-Ai Kim; Chi-Young Shim; Jin-Mi Kim; Hyun-Jin Lee; Dong-Hoon Choi; Eui-Young Choi; Yangsoo Jang; Namsik Chung; Jong-Won Ha // Heart;Aug2011, Vol. 97 Issue 15, p1233 

    Background Left ventricular longitudinal diastolic functional reserve (DFR), as assessed by the change in early diastolic mitral annular velocity (E') during exercise, is abnormal in patients with type 2 diabetes mellitus (DM). However, the impact of left ventricular longitudinal DFR on clinical...

  • Estimate of the diabetic retinopathy hazard rates in type 2 diabetic patients with current status data. Askarishahi, Mohsen; Hajizadeh, Ebrahim; Afkhami-Ardekani, Mohammad; Manaviat, Masoud // International Journal of Diabetes in Developing Countries;Dec2012, Vol. 32 Issue 4, p203 

    Diabetes Retinopathy is an important microvascular complication of diabetes mellitus and estimation of the retinopathy prevalence from cross sectional data is very important. This study is to estimate the hazard rate of diabetic retinopathy when only cross sectional data measuring diabetes...

  • Arterial Stiffness Is Associated With Incident Albuminuria and Decreased Glomerular Filtration Rate in Type 2 Diabetic Patients. BOUCHI, RYOTARO; BABAZONO, TETSUYA; MUGISHIMA, MICHINO; YOSHIDA, NAOSHI; NYUMURA, IZUMI; TOYA, KIWAKO; HANAI, KO; TANAKA, NOBUE; ISHII, AKIKO; UCHIGATA, YASUKO; IWAMOTO, YASUHIKO // Diabetes Care;Dec2011, Vol. 34 Issue 12, p2570 

    OBJECTIVE--To investigate the association between aortic stiffness and incident albuminuria and the decline in estimated glomerular filtration rate (eGFR) in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS--We investigated 461 Japanese type 2 diabetic patients, comprising 199 women...

  • Estimation of 10-Year Risk of Coronary Heart Disease in Nepalese Patients with Type 2 Diabetes: Framingham Versus United Kingdom Prospective Diabetes Study. Ram Pokharel, Daya; Khadka, Dipendra; Sigdel, Manoj; Kishor Yadav, Naval; Bahadur Sapkota, Lokendra; Kafle, Ramchandra; Nepal, Sarthak; Mohan Sapkota, Ravindra; Choudhary, Niraj // North American Journal of Medical Sciences;Aug2015, Vol. 7 Issue 8, p347 

    Background: Predicting future coronary heart disease (CHD) risk with the help of a validated risk prediction function helps clinicians identify diabetic patients at high risk and provide them with appropriate preventive medicine. Aim: The aim of this study is to estimate and compare 10-year CHD...

  • Association of 1,5-Anhydroglucitol With Cardiovascular Disease and Mortality. Selvin, Elizabeth; Rawlings, Andreea; Lutsey, Pamela; Maruthur, Nisa; Pankow, James S.; Steffes, Michael; Coresh, Josef // Diabetes;Jan2016, Vol. 65 Issue 1, p201 

    In diabetes, low concentrations of the biomarker 1,5-anhydroglucitol (1,5-AG) reflect hyperglycemic excursions over the prior 1-2 weeks. To the extent that hyperglycemic excursions are important in atherogenesis, 1,5-AG may provide independent information regarding cardiovascular risk....

  • ROADMAP and ORIENTAL Trials: the Re-emergence of J-Curve Ghost? Hamamoto, Yoshiyuki; Koshiyama, Hiroyuki // Japanese Clinical Medicine;2011, Issue 2, p25 

    It still remains unknown whether angiotensin-receptor blockers (ARBs) are cardioprotective in patients with type 2 diabetes. The recent two clinical trials, the ROADMAP and the ORIENT, have suggested that fatal cardiovascular events or cardiovascular deaths were unexpectedly higher in olmesartan...

  • Heart Rate Response During Positive Exercise Stress Test Predicts Coronary Artery Disease and Its Severity in High-Risk Type 2 Diabetic Patients With Silent Ischemia. Bacci, Simonetta; Iangialonga, Tommaso; Villella, Massimo; Rauseo, Anna; Fanelli, Raffaele; Trischitta, Vincenzo // Diabetes Care;Sep2003, Vol. 26 Issue 9, p2698 

    Examines the role of heart rate response during positive exercise stress test in predicting coronary artery disease and its severity in high risk type 2 diabetic patients with silent ischemia. Prediction of three-vessel disease in patients with maximal heart rate less than beats per minute.

  • Association of Hypoglycemia and Cardiac Ischemia. Desouza, Cyrus; Salazar, Holger; Cheong, Benjamin; Murgo, Joseph; Fonseca, Vivian // Diabetes Care;May2003, Vol. 26 Issue 5, p1485 

    OBJECTIVE — In some studies intensive diabetes treatment in patients with type 2 diabetes may be associated with increased cardiovascular events. It is not clear whether these events are related to hypoglycemic episodes. To determine whether episodes of hypoglycemia were more likely to be...

  • Enhancing macrovascular outcomes in DM2. Kuritzky, Louis // Clinical Oncology Alert;Aug2009 Supplement, p15 

    The article discusses research which investigated the outcome of various therapies in a group of patients with type 2 diabetes mellitus (DM2) with established coronary artery disease (CAD). It references a study published in the "New England Journal of Medicine." The therapies investigated...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics