Christianson et al developed a "pen and paper" risk estimator for coronary heart disease (CHD) in a patient with Type 2 diabetes. This can help identify a patient who may benefit from more aggressive management of risk factors. The authors are from the Mayo Clinic.
NOTE: The risk estimator is based on the UKPDS risk equation.
Parameters:
(1) age and gender
(2) duration of diabetes in years
(3) smoking status
(4) hemoglobin A1c in percent
(5) systolic blood pressure in mm Hg
(6) total cholesterol to HDL cholesterol ratio
(7) urinary microalbumin in micrograms per minute
Parameter |
Finding |
Points |
---|---|---|
age and gender |
female and < 60 years |
0 |
|
female and 60 - 74.9 years |
9 |
|
female and >= 75 years |
22 |
|
male and < 60 years |
6 |
|
male and 60 - 74.9 years |
20 |
|
male and >= 75 years |
41 |
duration of diabetes in years |
< 5 years |
0 |
|
5 - 9.9 years |
2 |
|
>= 10 years |
5 |
smoking status |
never |
0 |
|
former |
0 |
|
current |
2 |
percent hemoglobin A1c |
< 7% |
0 |
|
7.0 - 7.9% |
2 |
|
>= 8.0% |
6 |
systolic blood pressure |
< 120 mm Hg |
0 |
|
120 - 139 mm Hg |
1 |
|
>= 140 mm Hg |
4 |
total cholesterol to HDL cholesterol ratio |
< 4.0 |
0 |
|
4.0 - 5.9 |
6 |
|
>= 6.0 |
10 |
microalbuminuria |
< 30 micrograms per minute |
0 |
|
>= 30 micrograms per minute |
1 |
where:
• Microalbumin in micrograms per minute probably requires a 24 hour urine, with 24 hours = 1440 minutes and 1 mg = 1000 micrograms.
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 69
• The higher the score the greater the risk of coronary heart disease.
Total Score |
Risk Group |
Probability of CHD in Next 10 Years |
---|---|---|
<= 17 |
average |
< 15% |
18 - 31 |
elevated |
15 - 30% |
>= 32 |
high |
> 30% |
Purpose: To predict the risk of coronary heart disease in the next 10 years for a patient with type 2 diabetes using the risk estimator of Christianson et al.
Specialty: Cardiology
Objective: risk factors, severity, prognosis, stage, complications
ICD-10: E10-E14,