Cardiovascular risk assessment scores for people with diabetes: a systematic review
Open accessAbstract
People with type 2 diabetes have an increased risk of cardiovascular disease (CVD). Multivariate cardiovascular risk scores have been used in many countries to identify individuals who are at high risk of CVD. These risk scores include those originally developed in individuals with diabetes and those developed in a general population. This article reviews the published evidence for the performance of CVD risk scores in diabetic patients by: (1) examining the overall rationale for using risk scores; (2) systematically reviewing the literature on available scores; and (3) exploring methodological issues surrounding the development, validation and comparison of risk scores. The predictive performance of cardiovascular risk scores varies substantially between different populations. There is little evidence to suggest that risk scores developed in individuals with diabetes estimate cardiovascular risk more accurately than those developed in the general population. The inconsistency in the methods used in evaluation studies makes it difficult to compare and summarise the predictive ability of risk scores. Overall, CVD risk scores rank individuals reasonably accurately and are therefore useful in the management of diabetes with regard to targeting therapy to patients at highest risk. However, due to the uncertainty in estimation of true risk, care is needed when using scores to communicate absolute CVD risk to individuals.
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Risk estimator tools, especially for CVD risk, work best when they are derived from and/or are validated in a population similar to the population in which they are applied.
“Risk estimator tools, especially for CVD risk, may also be helpful, but when using these tools one must be aware that they work best when they are derived from and/or are validated in a population similar to the population in which they are applied (307).”
From Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) (2022) · cites this paper as [307]
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- Authors
- Chamnan, P., Simmons, R. K., Sharp, S. J., Griffin, S. J., & Wareham, N. J.
- Affiliations
- Addenbrooke's Hospital (GB)
- Corresponding author
- Wareham, N. J.
- Venue
- Diabetologia
- Published
- 2009-07-24
- Volume
- 52
- Issue
- 10
- Pages
- 2001-2014
- ISSN
- 0012-186X (ISSN-L)
- 1432-0428
- PMC
- PMC2744770
- OpenAlex
- W1969752830
- Cited by
- 176
- References
- 66
- Citations by year
- 2026: 7 · 2025: 4 · 2024: 3 · 2023: 11 · 2022: 11 · 2021: 10 · 2020: 4 · 2019: 9 · 2018: 11 · 2017: 13 · 2016: 13 · 2015: 19 · 2014: 20 · 2013: 17 · 2012: 4
- FWCI
- 1.05
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- Diabetologia (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of Cambridge
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- cardiovascular risk score, type 2 diabetes, cardiovascular risk, risk prediction, risk score validation, risk score comparison, predictive performance, risk communication, diabetes management
- MeSH terms
- Cardiovascular Diseases, Diabetes Mellitus, Type 2, Humans, Risk Factors, Risk Assessment
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