Patients with diabetes
Patients with diabetes constitute the second high-risk group. The frequency of cardiovascular events (SSSob) and mortality among patients with diabetes is much higher than in the general population, so these patients need “aggressive” preventive interventions. The third group of patients who are at high risk for SCSS and death are patients with CKD, many of whom suffer from diabetes.
For patients without CVD and diabetes, several risk determination strategies based on risk factors (RF) have been developed. Early versions of some manuals recommended a simple calculation of DF. The Framingham Heart Study researchers have developed a handy tool for assessing the risk of a first SSSob, taking into account age, gender, cholesterol, LDL, LDL, GL, DAD, diabetes, and smoking. Points are assigned if and depending on the level of each FR.
After the summation of points, the absolute risk of coronary heart disease (CHD) is assessed over the next 10 years. The National Heart, Lung, and Blood Institute posted an affordable online 10-year risk calculator. Researchers at the Framingham Heart Study also developed scales for determining the risk of secondary prevention of MI and MI. However, due to the fact that patients with CVDs already have a high risk of recurrent CVDs and need “aggressive” prevention, the benefits of this tool remain unclear.
There are several alternatives to the Framingham risk scale. The HeartScore project (Heart Systematic Coronary Risk Evaluation) was created by a European working group based on cohort studies involving> 200 thousand people in 12 European countries.
HeartScore replaced the earlier risk stratification patterns common to the European Society of Cardiology, and shifted the focus from warning KBS to warning CVD. On the basis of age, sex, SAD, CHF, or HCV HDL ratio, HeartScore calculates the 10-year risk of death from CVD, rather than the risk of individual cardiovascular events (SSSob). SD in this scale was not included, because he was not studied in the cohorts used to create the scale. For patients with a 10-year risk of fatal events> 5%, aggressive intervention is recommended.
Another risk assessment tool was created based on the PROCAM study, which for a long time (from 1979 to 1985) monitored for> 5 thousand men aged 35–65 years. In the PROCAM FR algorithm, there were smoking, GARDEN, LDL CH and HDL cholesterol, fasting TG, as well as diabetes, MI in the family history and age. Answers in points to questions regarding these DFs are summarized, as in the Framingham risk scale, and the 10-year absolute risk of fatal or nonfatal IM BCC is determined by the results.