Echouffo-Tcheugui Justin B, Ogunniyi Modele O, Kengne André P
Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
ISRN Cardiol. 2011;2011:242656. doi: 10.5402/2011/242656. Epub 2011 Nov 23.
Purpose. To examine the usefulness of cardiovascular risk estimation models in people with diabetes. Methods. Review of published studies that compare the discriminative power of major cardiovascular risk factors single or in combination in individuals with and without diabetes, for major cardiovascular outcomes. Results. In individuals with and without diabetes, major risk factors affect cardiovascular risk similarly, with no evidence of any significant interaction. Accounting for diabetes-specific parameters, cardiopreventative therapies can significantly improve risk estimation in diabetes. General and diabetes-specific cardiovascular risk models have a useful discriminative power, but tend to overestimate risk in individuals with diabetes. Their impact on care delivery, adherence to therapies, and patients' outcome remain poorly understood. Conclusions. The high-risk status conferred by diabetes does not preclude the estimation of absolute cardiovascular risk estimation using global risk tools in individuals with diabetes, as this is useful for the initiation and intensification of preventive measures.
目的。探讨心血管风险评估模型在糖尿病患者中的实用性。方法。回顾已发表的研究，这些研究比较了主要心血管危险因素单独或联合对有糖尿病和无糖尿病个体主要心血管结局的判别能力。结果。在有糖尿病和无糖尿病个体中，主要危险因素对心血管风险的影响相似，没有任何显著相互作用的证据。考虑到糖尿病特异性参数，心脏预防治疗可显著改善糖尿病患者的风险评估。通用和糖尿病特异性心血管风险模型具有有用的判别能力，但往往高估糖尿病患者的风险。它们对医疗服务提供、治疗依从性和患者结局的影响仍知之甚少。结论。糖尿病赋予的高风险状态并不排除使用全球风险工具对糖尿病患者进行绝对心血管风险评估，因为这对启动和强化预防措施很有用。
