J Lipid Atheroscler.  2018 Dec;7(2):110-121. 10.12997/jla.2018.7.2.110.

Prediction of Coronary Heart Disease Risk in Korean Patients with Diabetes Mellitus

• Koo BK
• Oh S
• Kim YJ
• Moon MK

• KMID: 2429831
• DOI: http://doi.org/10.12997/jla.2018.7.2.110

Abstract

OBJECTIVE
We developed a new equation for predicting coronary heart disease (CHD) risk in Korean diabetic patients using a hospital-based cohort and compared it with a UK Prospective Diabetes Study (UKPDS) risk engine.
METHODS
By considering patients with type 2 diabetes aged ≥30 years visiting the diabetic center in Boramae hospital in 2006, we developed a multivariable equation for predicting CHD events using the Cox proportional hazard model. Those with CHD were excluded. The predictability of CHD events over 6 years was evaluated using area under the receiver operating characteristic (AUROC) curves, which were compared using the DeLong test.
RESULTS
A total of 732 participants (304 males and 428 females; mean age, 60±10 years; mean duration of diabetes, 10±7 years) were followed up for 76 months (range, 1-99 month). During the study period, 48 patients (6.6%) experienced CHD events. The AUROC of the proposed equation for predicting 6-year CHD events was 0.721 (95% confidence interval [CI], 0.641-0.800), which is significantly larger than that of the UKPDS risk engine (0.578; 95% CI, 0.482-0.675; p from DeLong test=0.001). Among the subjects with <5% of risk based on the proposed equation, 30.6% (121 out of 396) were classified as ≥10% of risk based on the UKPDS risk engine, and their event rate was only 3.3% over 6 years.
CONCLUSION
The UKPDS risk engine overestimated CHD risk in type 2 diabetic patients in this cohort, and the proposed equation has superior predictability for CHD risk compared to the UKPDS risk engine.

Keyword

Coronary heart disease; Diabetes mellitus; Korea

MeSH Terms

Cohort Studies
Coronary Disease*
Diabetes Mellitus*
Female
Humans
Korea
Male
Proportional Hazards Models
Prospective Studies
ROC Curve

Figure

• 

  Fig. 1 Predictability of the new equation for 6-year CHD events compared to UKPDS risk engine. The predictability of the new equation and UKPDS risk engine in each year from the baseline was estimated by AUROC. AUROC was compared using DeLong test. CHD; coronary heart disease, UKPDS; UK Prospective Diabetes Study, AUROC; area under the receiver operating characteristic. *p<0.05.

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