DM-CURE Risk Score of Lin et al for Predicting Incident Heart Failure in a Patient with Type 2 Diabetes

Description

Lin et al reported the DM-CURE risk score for predicting the risk of incident congestive heart failure in a patient with type 2 diabetes. The authors are from Tulane University and the University of Florida Gainesville.

DM-CURE is an acronym for demographics, metabolic, complications, utilization, risk evaluation.

Patient selection: adult (>= 18 years) type 2 diabetes

Parameters:

(1) age at diabetes diagnosis

(2) college education

(3) systolic blood pressure in mm Hg

(4) body mass index in kg per square meter

(5) serum HDL in mg/dL

(6) sex

(7) history of myocardial infarction

(8) history of coronary revascularization

(9) cardiovascular medications

(10) history of neuropathy

(11) duration of hypertension in years

(12) history of albuminuria

(13) urine albumin to creatinine ratio

(14) end-stage kidney disease

(15) hospitalization in current year (presumably calendar)

(16) ED visit in current year (presumably calendar)

Parameter	Finding	Points
age at diagnosis	18 to 45 years	0
	45 to 65 years	5
	> 65 years	12
college education	no	0
	yes	-5
systolic blood pressure	< 120 mm Hg	0
	120 to 140 mm Hg	1
	> 140 mm Hg	5
body mass index	<= 30 kg per sq m	0
	> 30 kg per sq m	3
serum HDL	male and > 40 mg/dL	-2
	female and > 50 mg/dL	-2
	other	0
history myocardial infarct	no	0
	yes	5
history of revascularization	no	0
	yes	6
cardiovascular medications	no	0
	yes	5
neuropathy	no	0
	yes	3
duration of hypertension	<= 5 years	-1
	6 to 10 years	0
	11 to 15 years	1
	16 to 34 years	2
history of albuminuria	no	0
	yes	4
UACR	< 30 mg/g	0
	30 to 300 mg/g	4
	> 300 mg/g	8
end-stage kidney disease	no	0
	yes	6
hospitalization in current year	no	0
	yes	5
number of ED visits	0	0
	1	1
	>= 2	7

where:

• Hemoglobin A1c was not included in the score.

total score =

= SUM(points for all of the parameters)

Interpretation:

• minimum score: -8

• maximum score: 71

Total Score	Estimated Risk	Risk Category
<= 14	< 1%	low
15 to 23	1 to 5%	low
24 to 27	5 to 10%	low
28 to 33	10 to 20%	intermediate
> 33	> 20%	high

Performance:

• The area under the ROC curve is 0.81.

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DM-CURE Risk Score of Lin et al for Predicting Incident Heart Failure in a Patient with Type 2 Diabetes

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