Read SH, et al. - In the present study, researchers assessed the performance of five cardiovascular disease (CVD) risk scores developed in diabetes populations and compared their performance to QRISK2. Among people with newly diagnosed type 2 diabetes, none of the risk scores performed well. The study findings suggested that using these risk scores to forecast 5-year CVD risk in this population might not be appropriate.

Methods

• Between 2004 and 2016, a cohort of people diagnosed with type 2 diabetes was identified from the Scottish National Diabetes Register (NDR).
• Using linked hospital and death records, CVD events were identified.
• Using each of QRISK2, ADVANCE, Cardiovascular Healthy Study (CHS), New Zealand Diabetes Cohort Study (NZ DCS), Fremantle Diabetes Study, and Swedish NDR risk scores, 5-year risk of CVD was estimated.
• Using Harrell’s C statistic and calibration plots, discrimination and calibration were evaluated, respectively.

Results

• The external validation cohort comprised of 181,399 individuals with type 2 diabetes and no history of CVD.
• It was observed that there were 14,081 incident CVD events within 5 years of follow-up.
• It was noted that the 5-year observed risk of CVD was 9.7% (95% CI 9.6, 9.9).
• Findings revealed that C statistics varied between 0.66 and 0.67 for all risk scores.
• Data reported that QRISK2 overestimated risk, classifying 87% to be at elevated risk for developing CVD within 5 years.
• ADVANCE underestimated risk, and the Swedish NDR risk score calibrated well to observed risk.