Refining Long-Term Prediction of Cardiovascular Risk in Diabetes - The VILDIA Score.

Goliasch, Georg; Silbernagel, Günther; Kleber, Marcus E; Grammer, Tanja B; Pilz, Stefan; Tomaschitz, Andreas; Bartko, Philipp E; Maurer, Gerald; Koenig, Wolfgang; Niessner, Alexander; März, Winfried

doi:10.1038/s41598-017-04935-8

journal article

Document type:: Journal Article; Article
Author(s):: Goliasch, Georg; Silbernagel, Günther; Kleber, Marcus E; Grammer, Tanja B; Pilz, Stefan; Tomaschitz, Andreas; Bartko, Philipp E; Maurer, Gerald; Koenig, Wolfgang; Niessner, Alexander; März, Winfried
Title:: Refining Long-Term Prediction of Cardiovascular Risk in Diabetes - The VILDIA Score.
Abstract:: Cardiovascular risk assessment in patients with diabetes relies on traditional risk factors. However, numerous novel biomarkers have been found to be independent predictors of cardiovascular disease, which might significantly improve risk prediction in diabetic patients. We aimed to improve prediction of cardiovascular risk in diabetic patients by investigating 135 evolving biomarkers. Based on selected biomarkers a clinically applicable prediction algorithm for long-term cardiovascular mortality was designed. We prospectively enrolled 864 diabetic patients of the LUdwigshafen RIsk and Cardiovascular health (LURIC) study with a median follow-up of 9.6 years. Independent risk factors were selected using bootstrapping based on a Cox regression analysis. The following seven variables were selected for the final multivariate model: NT-proBNP, age, male sex, renin, diabetes duration, Lp-PLA2 and 25-OH vitamin D3. The risk score based on the aforementioned variables demonstrated an excellent discriminatory power for 10-year cardiovascular survival with a C-statistic of 0.76 (P < 0.001), which was significantly better than the established UKPDS risk engine (C-statistic = 0.64, P < 0.001). Net reclassification confirmed a significant improvement of individual risk prediction by 22% (95% confidence interval: 14-30%) compared to the UKPDS risk engine (P < 0.001). The VILDIA score based on traditional cardiovascular risk factors and reinforced with novel biomarkers outperforms previous risk algorithms.
Journal title abbreviation:: Sci Rep
Year:: 2017
Journal volume:: 7
Journal issue:: 1
Pages contribution:: 4700
Language:: eng
Fulltext / DOI:: doi:10.1038/s41598-017-04935-8
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/28680124
Print-ISSN:: 2045-2322
TUM Institution:: Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (Prof. Schunkert)
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