Prediction of individual life-years gained without cardiovascular events from lipid, blood pressure, glucose, and aspirin treatment based on data of more than 500,000 patients with Type 2 diabetes mellitus
European Heart Journal Jan 14, 2019
Berkelmans GFN, et al. - Researchers used data from 389,366 type 2 diabetics registered in the Swedish National Diabetes Registry to develop and validate a prediction tool (the Diabetes Lifetime-perspective prediction model, consisting of two complementary competing risk adjusted Cox proportional hazards functions) for individualizing lifelong cardiovascular disease (CVD) prevention and predicting life-years gained without myocardial infarction or stroke in these patients. They also used data from the ADVANCE, ACCORD, ASCOT and ALLHAT-LLT-trials, the SMART and EPIC-NL cohorts, and the Scottish diabetes register (total n=197,785) to externally validate the tool. In all validation sets, they observed good agreement between predicted and observed CVD-free survival. For internal and external validation, the respective C-statistics for prediction of CVD were 0.83 and 0.64–0.65. According to findings, readily available clinical characteristics can allow estimation of CVD-free life expectancy and influences of lifelong prevention in terms of CVD-free life-years gained for type 2 diabetics. With predictions of individual-level treatment effects, trial results can be translated to individual patients.
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