Discrimination and stratification tests of cardiovascular disease risk assessment models against ultrasound detection of carotid plaques in type 2 diabetics

Abstract

Atherosclerosis is the early stage of arterial disease, and underlies development of cardio- vascular disease (CVD) and stroke. Although sophisticated models for assessing CVD and stroke risk have been derived based on large- scale prospective studies, their abilities in detect- ing the presence or absence of atherosclerotic plaque have not been investigated. This study aimed to evaluate and compare discriminatory and risk stratifying abilities of 13 CVD risk as- sessment models against the ultrasound detec- tion of carotid plaques in type 2 diabetes melli- tus (T2DM) patients. Forty-nine T2DM subjects were recruited with informed consent, and major anthropomorphic and biomarker data for these models were collected. The model risk scores were evaluated against the carotid plaques de- tected by Doppler ultrasound. Only the FHS- Lpts-CHD-10Y model, which is a variant of the Framingham model, revealed an area under the receiver operating curve (AUROC) that was sig- nificantly different from a random scoring ap- proach (AUROC: 0.681, p < 0.05), and was able to stratify the risk levels of carotid plaque pre- sence (Chi-Square statistic: 5.99, p < 0.05).