According to some studies, the age of diagnosis and the time course of the disease play a role in its progression, and after 10 to 15 years, the coronary risk of these diabetic patients is similar to patients with prior CHD. Type 2 diabetes patients without other CVRF have a lower risk of CVD, especially patients with a shorter evolution of the disease and with fewer metabolic alterations. It might be related to multiple causes, such as those attributable to the different baseline characteristics and different risk profiles of the diabetic patients who participated in the studies. Although diabetes is a risk factor for Coronary Heart Disease (CHD), whether diabetes alone is a CHD equivalent in assessing de risk of future CVD events is controversial. Incidence of diabetes is expected to continue to increase over in the following years and CVD associated with DM2 will most likely increase as well. This risk is two to four times higher in DM2 patients than in non-DM2 patients, independently of the classical cardiovascular risk factors (CVRF). Type 2 diabetes mellitus (DM2) is associated with an increased risk of cardiovascular disease (CVD). The results of this study indicate the need for a prospective study which validates specific equations for diabetic patients in the Spanish population, as well as research on new models for cardiovascular risk prediction in these patients. There are discrepancies between the general population and the type 2 diabetic patient-specific risk engines. The agreement values in the allocation of a particular patient to the high risk group was low between the REGICOR engine and the UKPDS and ADVANCE engines ( k = 0.205 and k = 0.123, respectively p < 0.0001) and acceptable between the ADVANCE and UKPDS risk engines ( k = 0.608). The correlation using the REGICOR risk engine was low compared to UKPDS and ADVANCE ( r = 0.288 and r = 0.153, respectively p < 0.0001). The ADVANCE and UKPDS risk engines identified a higher number of diabetic patients with a high cardiovascular risk (24.2 % and 22.7 %, respectively) compared to the REGICOR risk engine (10.2 %). A patient was considered to have a high cardiovascular risk when REGICOR ≥ 10 % or UKPDS ≥ 15 % in 10 years or when ADVANCE ≥ 8 % in 4 years. The risk function and probability that a cardiovascular disease could occur were estimated using three risk engines: REGICOR, UKPDS and ADVANCE. The demographic, clinical, analytical, and cardiovascular risk factor variables associated with type 2 diabetes were analysed.
Multicentre, cross-sectional descriptive study of 3,041 patients with type 2 diabetes and no history of cardiovascular disease. The principal objective of this study was to assess three different cardiovascular risk prediction models in type 2 diabetes patients. Some authors consider that secondary prevention should be conducted for all DM2 patients, while others suggest that the drug preventive treatment should start or be increased depending on each patient’s individual CVR, estimated using cardiovascular or coronary risk functions to identify the patients with a higher CVR.
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