SCORE2-Diabetes

This function calculates the 10-year cardiovascular risk estimation for patients aged 40 to 69 years with type 2 diabetes without atherosclerotic cardiovascular disease (ASCVD) or severe target organ damage (TOD) using the doi:10.1093/eurheartj/ehad260 SCORE2-Diabetes algorithm. Risk score is expressed as percentage in one decimal place. It also categorises these patients into different risk groups.

Usage

SCORE2_Diabetes(
  Risk.region,
  Age,
  Gender,
  smoker,
  systolic.bp,
  total.chol,
  total.hdl,
  diabetes,
  diabetes.age,
  HbA1c,
  eGFR,
  classify = FALSE
)

Arguments

Risk.region

Input character to indicate an European risk region group the patient belongs to. The allowed categories are

• Low

• Moderate

• High

• Very high

Age

Input positive integer to indicate the age of the patient.

Gender

Input character to indicate an European risk region group the patient belongs to. The allowed categories are

• male

• female

smoker

Input integer 0 or 1 to indicate if the patient is a current smoker.

• 0 stands for patient is either a former/past smoker or a non-smoker.

• 1 stands for patient is a current smoker.

systolic.bp

Input positive numeric value to indicate the patient's systolic blood pressure in \(mm HG\).

total.chol

Input positive numeric value to indicate the patient's total cholesterol in \(mmol/L\).

total.hdl

Input positive numeric value to indicate the patient's high-density lipoprotein (HDL) in \(mmol/L\).

diabetes

Input integer 0 or 1 to indicate if the patient has diabetes.

• 0 stands for not having diabetes.

• 1 stands for having diabetes.

diabetes.age

Input positive integer to indicate the age when the patient is diagnosed with diabetes. It can be set to NA if patient is not diabetic.

HbA1c

Input positive numeric value to indicate the patient's hemoglobin A1C (HbA1c) in \(mmol/mol\).

eGFR

Input positive numeric value to indicate the patient's estimated glomerular filtration rate (eGFR) in \(ml/min/1.73m^2\).

classify

When set to TRUE, the function will return the patient's risk group based on the SCORE2-Diabetes risk score in percentage rounded to one decimal place. Default: FALSE.

Risk groups are classified based on Figure 3 from the doi:10.1093/eurheartj/ehad192 2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes:

SCORE2-Diabetes Score	10-year Cardiovascular Disease (CVD) Risk Group
\(<5\%\)	Low risk
\(5\%\) to \(<10\%\)	Moderate risk
\(10\%\) to \(<20\%\)	High risk
\(\ge20\%\)	Very high risk

Value

SCORE2-Diabetes risk doi:10.1093/eurheartj/ehad260 score expressed as a positive percentage rounded to one decimal place when classify is FALSE. A patient's risk group when classify is TRUE.

Details

doi:10.1093/eurheartj/ehad260 was developed by extending the SCORE2 doi:10.1093/eurheartj/ehad260 algorithms using 229460 participants (43706 CVD events) with type 2 diabetes and without previous CVD from four population data sources [Scottish Care Information—Diabetes (SCID), Clinical Practice Research Datalink (CPRD), UK Biobank (UKB), Emerging Risk Factors Collaboration (ERFC)] across seven countries (England, Wales, Scotland, France, Germany, Italy, and the USA).

References

Primary Paper

• SCORE2-Diabetes Working Group and the ESC Cardiovascular Risk Collaboration, SCORE2-Diabetes: 10-year cardiovascular risk estimation in type 2 diabetes in Europe, Eur Heart J, 44:2544–2556, doi:10.1093/eurheartj/ehad260

Clinical Practice Guidelines

• Marx N, Federici M, Schütt K, Müller-Wieland D, Ajjan RA,vAntunes MJ, Christodorescu RM, Crawford C, Angelantonio ED, Eliasson B, Espinola-Klein C, Fauchier L, Halle M, Herrington WG, Kautzky-Willer A, Lambrinou E, Lesiak M, Lettino M, McGuire DK, Mullens W, Rocca B, Sattar N, ESC Scientific Document Group, 2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes: Developed by the task force on the management of cardiovascular disease in patients with diabetes of the European Society of Cardiology (ESC), Eur Heart J, 44:4043–4140, doi:10.1093/eurheartj/ehad260

Examples

# 60 years old male from low risk region
# who is a non-smoker, diabetic at age 60
# with a systolic blood pressure of 140 mmHg,
# total cholesterol of 5.5 mmol/L,
# HDL cholesterol of 1.3 mmol/L,
# HbA1c of 50 mmol/mol and
# eGFR of 90 mL/min/1.73m2
# will have a risk score of 8.4 and
# at moderate risk of CVD.

SCORE2_Diabetes(
  Risk.region = "Low",
  Age = 60,
  Gender = "male",
  smoker = 0,
  systolic.bp = 140,
  total.chol = 5.5,
  total.hdl = 1.3,
  diabetes = 1,
  diabetes.age = 60,
  HbA1c = 50,
  eGFR = 90,
  classify = FALSE
)
#> [1] 8.4

SCORE2_Diabetes(
  Risk.region = "Low",
  Age = 60,
  Gender = "male",
  smoker = 0,
  systolic.bp = 140,
  total.chol = 5.5,
  total.hdl = 1.3,
  diabetes = 1,
  diabetes.age = 60,
  HbA1c = 50,
  eGFR = 90,
  classify = TRUE
)
#> [1] "Moderate risk"