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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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Cardiovascular Diabetology

ISSN: 1475-2840