Coronary heart disease risk assessment in diabetes mellitus - a comparisonof PROCAM and Framingham risk assessment functions

Fl. Game et Af. Jones, Coronary heart disease risk assessment in diabetes mellitus - a comparisonof PROCAM and Framingham risk assessment functions, DIABET MED, 18(5), 2001, pp. 355-359
Citations number
Categorie Soggetti
Endocrynology, Metabolism & Nutrition
Journal title
ISSN journal
0742-3071 → ACNP
Year of publication
355 - 359
SICI code
Aims To assess any differences between coronary heart disease (CHD) risks c alculated by the Framingham equation and those calculated by the PROCAM equ ation in men with and without diabetes mellitus, and whether any such diffe rences are associated with the hypertriglyceridaemia of diabetes mellitus. Methods Clinical and biochemical data collected from 1774 men seen in eithe r general practice, a hospital diabetes or lipid clinic. CHD risks were cal culated by both the Framingham and PROCAM functions and comparisons made be tween those patients with and those without diabetes. Results Of the 1774 men only 996 fulfilled the criteria for assessment by t he PROCAM equation and thus further analysis. Patients with diabetes mellit us had significantly higher serum triglyceride levels than those without (1 .9 mmol/l vs. 1.7 mmol/l). Median annual CHD risks calculated by the Framin gham function were 1.7% in the patients with and 1.32% in the patients with out diabetes mellitus, whereas those calculated by the PROCAM function were 0.77% and 0.6%, respectively. Bland-Altman difference plots showed that in both groups of patients the PROCAM equation systematically underestimated risk in comparison with the Framingham equation at low levels of risk but o verestimated at higher levels of risk. The shape of the plots in each group of patients was, however, similar. Conclusion There were no systematic differences between CHD risks calculate d by the two different equations in patients with diabetes compared with th ose without, despite the higher serum triglyceride levels associated with d iabetes. Restrictions in the use of the PROCAM function meant that only 56% of the original cohort could be assessed in this way. Thus the Framingham equation remains the most suitable method of CHD risk prediction for UK pat ients with and without diabetes mellitus.