Comparisons of changes in the adapted diabetes complications severity index and CHA2DS2-VASc score for atrial fibrillation risk stratification in patients with type 2 diabetes mellitus: A nationwide cohort study. (15th October 2018)

• Record Type: Journal Article
• Authors: Hu, Wei-Syun; Hsieh, Meng-Hsuen; Lin, Cheng-Li
• Is Part Of: International journal of cardiology. Volume 269(2018)
• Page Start: 122
• Page End: 125
• Publication Date: 2018-10-15
• Subjects: Adapted diabetes complications severity index -- Atrial fibrillation -- CHA2DS2-VASc score -- Diabetes mellitus; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2018.07.010
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Purpose: This study describes the risk prediction of atrial fibrillation (AF) after incident type 2 diabetes mellitus (DM) with either progression of adapted diabetes complications severity index (DCSI) or CHA2 DS2 -VASc score in a large registry from Taiwan. Methods: The authors performed a retrospective nationwide cohort study by analyzing a Longitudinal Health Insurance Dataset, observing the ability of dynamic adapted DSCI and CHA2 DS2 -VASc score for AF risk discrimination in type 2 diabetic patients. The predictive performance of changes in the adapted DCSI and CHA2 DS2 -VASc score with regard to AF events was assessed using area under the curve of receiver operating characteristics (AUROC); and the difference between them was examined using the Delong test. Results: A total of 81, 655 new-onset type 2 DM patients were included in the study cohort. Among them, the AUROC for the adapted DCSI change in predicting AF (0.79, 95% CI = 0.78–0.80) was significantly higher than the change in CHA2 DS2 -VASc score (0.63, 95% CI = 0.62–0.64) with the DeLong test P < 0.001. Conclusions: Adapted DCSI change significantly outperforms the progression of CHA2 DS2 -VASc score with regard to AF prediction in type 2 diabetic patients. Highlights: This study is a nationwide retrospective study from the Longitudinal Health Insurance Database of Taiwan. The authors compared the accuracies of changes in adapted DSCI and CHA2DS2-VASc score for AF risk stratification in patients with newly-diagnosed type 2 diabetes mellitus, as defined by ICD-9 codes. The adapted DSCI change significantly performed better than the progression of CHA2DS2-VASc score in terms of predictive value.