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Olle Melander

Principal investigator

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The co-predictive value of a cardiovascular score for CV outcomes in diabetic patients with no atrial fibrillation

Author

  • Giuseppe Patti
  • Alessandro Sticchi
  • Vincenzo Pasceri
  • Fabrizio Ricci
  • Giulia Renda
  • Viktor Hamrefors
  • Olle Melander
  • Richard Sutton
  • Gunnar Engström
  • Raffaele De Caterina
  • Artur Fedorowski

Summary, in English

Background
Risk factors included in the cardiovascular (CHA2DS2‐VASc) score, currently used for atrial fibrillation (AF), may predispose to cardiovascular events whether or not AF is present. The aim was to explore the predictive role of CHA2DS2‐VASc score on cardiovascular outcomes in diabetic patients without AF.
Methods
We accessed individual data from 610 diabetic patients without AF at baseline included in the prospective cohort of the Malmö Diet and Cancer study. Main outcome measure was the occurrence of cardiovascular events (stroke, coronary events) and death. Mean follow‐up was 14.5 ± 5 years (8845 person/years).
Results
The CHA2DS2‐VASc score significantly predicted the risk of all outcome measures. There was a significant increase in stroke, coronary events, and death risk by each point of CHA2DS2‐VASc score elevation [stroke: adjusted hazard ratio (aHR) 1.43, 95% CI 1.14‐1.79, P = 0.001; coronary events: aHR 1.55, 95% CI 1.34‐1.80, P < 0.0001; death: aHR 1.94, 95% CI 1.71‐2.21, P < 0.0001]. A CHA2DS2‐VASc score ≥4 was associated with higher incidence of ischemic stroke (aHR 1.47, 95% CI 1.18‐1.82; P = 0.001), coronary events (aHR 1.32; 95% CI 1.11‐1.58; P = 0.002), and death (aHR 1.36; 95% CI 1.20‐1.54; P < 0.001).
Conclusions
In this population‐based study on diabetic patients without AF, the CHA2DS2‐VASc score was an independent predictor of ischemic stroke, coronary events, and overall mortality. Regardless of the AF status, the CHA2DS2‐VASc score might represent a rapid and user‐friendly tool for clinical assessment of diabetic patients at higher cardiovascular risk.

Department/s

  • Cardiovascular Research - Hypertension
  • EXODIAB: Excellence in Diabetes Research in Sweden
  • EpiHealth: Epidemiology for Health
  • Cardiovascular Research - Epidemiology

Publishing year

2019-07

Language

English

Pages

1-9

Publication/Series

Diabetes/Metabolism Research and Reviews

Volume

35

Issue

5

Document type

Journal article

Publisher

John Wiley and Sons

Topic

  • Cardiac and Cardiovascular Systems
  • Endocrinology and Diabetes

Status

Published

Research group

  • Cardiovascular Research - Hypertension
  • Cardiovascular Research - Epidemiology

ISBN/ISSN/Other

  • ISSN: 1520-7560