Journal Article

Assessing mortality risk in Type 2 Diabetes patients with prolonged ASCVD risk factors: the inclusive Poh-Ai predictive scoring system with CAC Score integration

Hsu, Jen-Te, Chen, Wan-Ming, Hsu, Yu-Chen, Hsiao, Ju-Feng, Chen, Chao-Chin, Chung, Sheng-Liang, Wu, Szu-Yuan, Lei, Meng-Huan, Chen, Wei-Cheng, Jao, An-Tzu

2024

Overview

Purpose To enhance the predictive risk model for all-cause mortality in individuals with Type 2 Diabetes (T2DM) and prolonged Atherosclerotic Cardiovascular Disease (ASCVD) risk factors. Despite the utility of the Coronary Artery Calcium (CAC) score in assessing cardiovascular risk, its capacity to predict all-cause mortality remains limited. Methods A retrospective cohort study included 1929 asymptomatic T2DM patients with ASCVD risk factors, aged 40–80. Variables encompassed demographic attributes, clinical parameters, CAC scores, comorbidities, and medication usage. Factors predicting all-cause mortality were selected to create a predictive scoring system. By using stepwise selection in a multivariate Cox proportional hazards model, we divided the patients into three risk groups. Results In our analysis of all-cause mortality in T2DM patients with extended ASCVD risk factors over 5 years, we identified significant risk factors, their adjusted hazard ratios (aHR), and scores: e.g., CAC score > 1000 (aHR: 1.57, score: 2), CAC score 401–1000 (aHR: 2.05, score: 2), and more. These factors strongly predict all-cause mortality, with varying risk groups (e.g., very low-risk: 2.0%, very high-risk: 24.0%). Significant differences in 5-year overall survival rates were observed among these groups (log-rank test < 0.001). Conclusion The Poh-Ai Predictive Scoring System excels in forecasting mortality and cardiovascular events in individuals with Type 2 Diabetes Mellitus and extended ASCVD risk factors.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Age / All-cause mortality / Angina pectoris / Arteriosclerosis / Asymptomatic / Atherosclerosis / Atherosclerotic cardiovascular disease / Body mass index / Calcification / Calcification (ectopic) / Cardiovascular disease / Cardiovascular diseases / Comorbidity / Coronary artery / Coronary artery calcium / Coronary vessels / Creatinine / Demographics / Diabetes / Diabetes mellitus (non-insulin dependent) / Endocrinology / Family medical history / Gender / Glucose / High density lipoprotein / Hypertension / Laboratories / Medical protocols / Medical research / Medicine / Medicine & Public Health / Medicine, Experimental / Metabolic Diseases / Mortality / Patient outcomes / Patients / Predictive scoring system / Prognosis / Review boards / Risk assessment / Risk factors / Risk groups / Smoking / Statistics / Taiwan / Type 2 diabetes / Vein & artery diseases