Risk of all-cause mortality according to the European Society of Cardiology risk categories in individuals with type 2 diabetes: the Renal Insufficiency And Cardiovascular Events (RIACE) Italian Multicenter Study.
Acta Diabetol
; 59(10): 1369-1381, 2022 Oct.
Article
en En
| MEDLINE
| ID: mdl-35902419
ABSTRACT
AIMS:
The 2019 and 2021 European Society of Cardiology (ESC) classifications stratified patients with type 2 diabetes into three categories according to the 10-year risk of death from atherosclerotic cardiovascular disease (ASCVD). The very high-risk category included individuals with established ASCVD, target organ damage (TOD), and/or, in the 2019 classification only, ≥ 3 additional ASCVD risk factors. We assessed risk of all-cause mortality according to the two ESC classifications in the Renal Insufficiency And Cardiovascular Events cohort.METHODS:
Participants (n = 15,773) were stratified based on the presence of ASCVD, TOD, and ASCVD risk factors at baseline (2006-2008). Vital status was retrieved in 2015.RESULTS:
Less than 1% of participants fell in the moderate-risk category. According to the 2019 classification, ~ 1/3 fell in the high-risk and ~ 2/3 in the very high-risk category, whereas the opposite occurred with the 2021 classification. Mortality risk increased across categories according to both classifications. Among very high-risk patients, mortality was much lower in those with ≥ 3 additional ASCVD risk factors and almost equal in those with TOD and ASCVD ± TOD, using the 2019 classification, whereas it was much higher in those with ASCVD + TOD and, to a lesser extent, TOD only than in those with ASCVD only, using the 2021 classification.CONCLUSIONS:
The negligible number of moderate-risk patients suggests that these classifications might overestimate risk of ASCVD death. Downgrading patients with ≥ 3 additional ASCVD risk factors to the high-risk category is consistent with mortality data. Risk of death is very high in the presence of TOD irrespective of established ASCVD. TRIAL REGISTRATION ClinicalTrials.gov, NCT00715481.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Cardiología
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Enfermedades Cardiovasculares
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Diabetes Mellitus Tipo 2
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Insuficiencia Renal
Tipo de estudio:
Clinical_trials
/
Etiology_studies
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Risk_factors_studies
Límite:
Humans
País como asunto:
Europa
Idioma:
En
Año:
2022
Tipo del documento:
Article