Abstract 012: Common Carotid Intima-Media Thickness Does not Add to the Framingham Risk Score in Individuals with Diabetes Mellitus: The USE-IMT Initiative
Objective—To investigate whether measurement of common carotid intima-media thickness (CIMT) has added value in cardiovascular risk prediction in individuals with diabetes mellitus.
Research Design and Methods—We performed a sub-analysis within USE-IMT, a large ongoing individual participant data meta-analysis involving 74,937 individuals from 17 population-based cohorts worldwide. We first refitted the risk factors of the Framingham heart risk score on the individualswithout previous cardiovascular disease (baseline model) and then expanded this model with common CIMT (CIMT model). The absolute 10-year risks to develop a myocardial infarction or stroke were estimated from both models. In individuals with diabetes mellitus (n=4,220) we compared discrimination and calibration of the two models. Reclassification of subjects was based on allocation to another cardiovascular risk category when common CIMT was added.
Results—During a median follow-up of 8.7 years, 684 first-time cardiovascular events occurred among the diabetic population. The c-statistic was 0.67 for the Framingham model, and 0.68 for the CIMT model. The absolute 10-year risk to develop a myocardial infarction or stroke in the diabetic population was 16% in both the baseline and common CIMT model. There was no net reclassification improvement with the addition of common CIMT (1.7%; 95% CI, -1.8 to 3.8%). Similar results were found for men and women.
Conclusions—There is no added value of measurement of common CIMT to the Framingham heart risk score among subjects with diabetes mellitus. Therefore, these measurements are not recommended for improving individual cardiovascular risk stratification in individuals with diabetes mellitus.
- © 2013 by American Heart Association, Inc.