title: A new model for 5-year risk of cardiovascular disease in type 2 diabetes, from the Swedish National Diabetes Register (NDR).
abstract: OBJECTIVE
  We assessed the association between risk factors and cardiovascular disease (CVD) in an observational study of type 2 diabetes patients from the Swedish National Diabetes Register.
  
  
  METHODS
  A derivation sample of 24,288 patients, aged 30-74 years, 15.3% with previous CVD, baseline 2002, 2488 CVD events when followed for 5 years until 2007. A separate validation data set of 4906 patients, baseline 2003, 522 CVD events when followed for 4 years.
  
  
  RESULTS
  Adjusted hazard ratios at Cox regression for fatal/nonfatal CVD were: onset-age 1.59, diabetes duration 1.55, total-cholesterol-to-HDL-cholesterol ratio 1.20, HbA1c 1.12, systolic BP 1.09, BMI 1.07 (1 SD increase in natural log continuous variables); males 1.41, smoker 1.35, microalbuminuria 1.27, macroalbuminuria 1.53, atrial fibrillation 1.50, previous CVD 1.98 (all p<0.001 except BMI p=0.0018). All 12 variables were used to elaborate an equation for 5-year CVD risk in the derivation dataset: mean 5-year risk 11.9±8.4%. Calibration in the validation dataset was adequate: ratio predicted 4-year risk/observed rate 0.97. Discrimination was sufficient: C statistic 0.72, sensitivity 51% and specificity 78% for top quartile.
  
  
  CONCLUSIONS
  This CVD risk model from a large observational study of patients in routine care showed adequate calibration and discrimination, and can be useful for clinical practice.
authors: Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden; Medical Products Agency, Section for Epidemiology, Uppsala, Sweden. Electronic address: bjorn.zethelius@pubcare.uu.se.
authors: Björn
authors: B
authors: Zethelius
authors: Department of Medicine, Sahlgrenska University Hospital, Gothenburgh University, Göteborg, Sweden.
authors: Björn
authors: B
authors: Eliasson
authors: Department of Medicine, Sahlgrenska University Hospital, Gothenburgh University, Göteborg, Sweden.
authors: Katarina
authors: K
authors: Eeg-Olofsson
authors: Center of Registers in Region Västra Götaland, Göteborg, Sweden.
authors: Ann-Marie
authors: AM
authors: Svensson
authors: Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden; Medical Products Agency, Section for Epidemiology, Uppsala, Sweden.
authors: Soffia
authors: S
authors: Gudbjörnsdottir
authors: Department of Public Health and Caring Sciences/Family Medicine and Clinical Epidemiology, Uppsala University, Uppsala, Sweden.
authors: Jan
authors: J
authors: Cederholm
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019370:Observation; D012042:Registries; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013548:Sweden