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Table 1 Risk models for MACE in the primary prevention population

From: Development of predictive risk models for major adverse cardiovascular events among patients with type 2 diabetes mellitus using health insurance claims data

  MACE MACE-plus CVD-related death
Validation
 C-statistic, training set 0.72 0.71 0.81
 C-statistic, validation set 0.72 0.72 0.81
Predictors OR (95% CI) P-value OR (95% CI) P-value OR (95% CI) P-value
Age group (reference: 50–54 years old)
 55–59 years old 1.25 (1.04, 1.51) 0.019* 1.19 (1.02, 1.38) 0.028* 1.02 (0.65, 1.59) 0.943
 60–64 years old 1.70 (1.43, 2.04) < 0.001* 1.59 (1.37, 1.83) < 0.001* 2.13 (1.43, 3.17) < 0.001*
 65–69 years old 1.70 (1.42, 2.04) < 0.001* 1.58 (1.36, 1.84) < 0.001* 2.35 (1.59, 3.49) < 0.001*
 70–74 years old 2.00 (1.66, 2.40) < 0.001* 1.85 (1.59, 2.16) < 0.001* 2.92 (1.96, 4.33) < 0.001*
 75–79 years old 2.49 (2.06, 3.00) < 0.001* 2.30 (1.97, 2.69) < 0.001* 4.12 (2.77, 6.13) < 0.001*
 80–84 years old 4.15 (3.45, 4.99) < 0.001* 3.48 (2.98, 4.05) < 0.001* 7.86 (5.31, 11.64) < 0.001*
 85 and above 4.48 (3.62, 5.55) < 0.001* 3.88 (3.24, 4.64) < 0.001* 7.96 (5.18, 12.23) < 0.001*
Female 0.73 (0.69, 0.78) < 0.001*    0.70 (0.63, 0.77) < 0.001*
Race (reference: Caucasian)
 African American      0.97 (0.81, 1.15) 0.708
 Asian      0.50 (0.31, 0.81) 0.005*
 Other/unknown      0.95 (0.83, 1.10) 0.514
Ethnicity (reference: non-Hispanic)
 Hispanic      0.52 (0.35, 0.78) 0.001*
 Unknown      1.29 (1.14, 1.47) < 0.001*
End of baseline period prior to 2011a 1.32 (1.23, 1.41) < 0.001* 1.35 (1.27, 1.43) < 0.001* 1.90 (1.71, 2.12) < 0.001*
Geographic region (reference: South)
 Midwest      0.84 (0.75, 0.95) 0.004*
 Northeast      0.57 (0.48, 0.68) < 0.001*
 West      0.77 (0.65, 0.91) 0.003*
 Other/unknown      0.89 (0.66, 1.21) 0.471
Insurance type (reference: health maintenance organization [HMO])
 Point-of-service (POS) 1.20 (1.03, 1.39) 0.020* 1.23 (1.09, 1.40) 0.001* 1.03 (0.75, 1.41) 0.841
 Preferred provider organization (PPO) 1.09 (0.95, 1.24) 0.210 1.17 (1.05, 1.31) 0.006* 1.09 (0.88, 1.35) 0.450
 Exclusive provider organization (EPO) 1.34 (1.06, 1.71) 0.015* 1.32 (1.08, 1.61) 0.007* 1.00 (0.59, 1.70) 0.996
 Indemnity (IND) 1.71 (1.38, 2.13) < 0.001* 1.78 (1.48, 2.13) < 0.001* 2.01 (1.40, 2.88) < 0.001*
 Other 0.90 (0.84, 0.97) 0.005* 0.94 (0.88, 1.00) 0.038* 0.95 (0.84, 1.07) 0.369
Payer type
 Commercial 0.53 (0.46, 0.61) < 0.001* 0.58 (0.51, 0.65) < 0.001* 0.46 (0.34, 0.60) < 0.001*
Other CVD-related conditions (i.e., conditions used to define CVD-related death) 1.19 (1.11, 1.28) < 0.001* 1.33 (1.26, 1.41) < 0.001* 1.10 (0.98, 1.23) 0.116
At least 1 diabetes-related hospitalization 1.36 (1.26, 1.46) < 0.001* 1.27 (1.19, 1.35) < 0.001* 1.42 (1.27, 1.59) < 0.001*
Adapted diabetes complications severity index 1.15 (1.13,1.17) < 0.001* 1.17 (1.15, 1.19) < 0.001* 1.19 (1.15, 1.23) < 0.001*
Recorded diagnoses (ref: no diagnosis)
 Hypertension    1.09 (1.01, 1.18) 0.024*   
 Chronic pulmonary disease 1.31 (1.22, 1.41) < 0.001* 1.36 (1.27, 1.44) < 0.001* 1.52 (1.35, 1.70) < 0.001*
 Cancer 1.14 (1.05, 1.24) 0.003* 1.12 (1.04, 1.20) 0.003* 1.52 (1.35, 1.72) < 0.001*
 Fluid and electrolyte disorders 1.20 (1.09, 1.32) < 0.001* 1.21 (1.11, 1.31) < 0.001* 1.22 (1.06, 1.40) 0.007*
 Deficiency anemia      1.22 (1.04, 1.43) 0.013*
 Coagulopathy 1.45 (1.25, 1.68) < 0.001* 1.37 (1.20, 1.56) < 0.001* 1.97 (1.60, 2.41) < 0.001*
 Pulmonary circulation disorders      1.32 (1.03, 1.69) 0.026*
Time interval (reference: 0–6 months)
 6–12 months 1.00 (0.91, 1.09) 0.980 0.97 (0.90, 1.05) 0.501 1.05 (0.90, 1.22) 0.527
 12–18 months 1.05 (0.95, 1.15) 0.363 1.02 (0.94, 1.11) 0.564 1.20 (1.02, 1.41) 0.025*
 18–24 months 0.96 (0.86, 1.08) 0.528 0.97 (0.88, 1.07) 0.531 1.15 (0.96, 1.38) 0.132
 24–30 months 1.06 (0.94, 1.20) 0.361 0.98 (0.88, 1.09) 0.664 1.20 (0.99, 1.47) 0.068
 30–36 months 1.02 (0.89, 1.17) 0.785 0.99 (0.88, 1.11) 0.826 1.27 (1.03, 1.57) 0.028*
 36–42 months 1.12 (0.96, 1.30) 0.141 1.06 (0.93, 1.21) 0.380 1.29 (1.02, 1.63) 0.035*
 42–48 months 0.98 (0.82, 1.17) 0.820 1.00 (0.86, 1.16) 0.970 1.02 (0.77, 1.35) 0.904
 48–54 months 1.07 (0.88, 1.29) 0.511 1.00 (0.84, 1.18) 0.971 1.39 (1.06, 1.83) 0.018*
 54–60 months 1.17 (0.95, 1.43) 0.138 1.00 (0.83, 1.21) 0.979 1.18 (0.85, 1.63) 0.328
 Over 60 months 1.02 (0.88, 1.18) 0.828 0.97 (0.86, 1.11) 0.693 0.93 (0.74, 1.18) 0.570
  1. CVD cardiovascular disease, MACE major adverse cardiovascular events, OR odds ratio, CI confidence interval
  2. * Indicates statistical significance at the 5% level
  3. aA glycated hemoglobin threshold (i.e., < 8%) was added to Healthcare Effectiveness Data and Information Set (HEDIS) measure for Comprehensive Diabetes Care in 2009 and to the Diabetes Recognition Program of the National Committee for Quality Assurance in 2010, which may have impacted CVD risk in patients with diabetes (See [43])
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