Internal Validation of the Metabo-Reno-Cardiovascular Disease Model: Risk of Recurrent Cardiovascular Events in a Population With and Without Diabetes

OBJECTIVES: The metabo-reno-cardiovascular-disease-model (MRCDM) is a patient-level model with individuals with or without diabetes (type 1 or 2), obesity (defined by BMI), cardiovascular disease (CVD) or chronic kidney disease. It was developed to predict the risk of complications and mortality in these individuals. The SMART-REACH equation was implemented to predict the risk of recurrent major cardiovascular events and interventions (MACE+) in patients with established CVD. The aim of this abstract was to validate the prediction of recurrent CVD events using this equation.

METHODS: Three different cohorts were evaluated, differing in baseline comorbidities: history of coronary heart disease (CHD), cerebrovascular disease (CeVD), and peripheral artery disease (PAD). The 3 cohorts were populated with the same baseline characteristics, coming from the SMART and REACH studies. Thirty-two percent were females, the starting age was 67 years, 34% of patients had diabetes, and 17% were smokers. Time horizon was ten years. Static risk factor progressions were applied. Predicted cumulative incidences (CI) of CVD were compared with observed risks predicted on the Extended SMART risk score calculator available online.

RESULTS: The Extended SMART risk score calculator predicts 10-year risk of recurrent CVD of 39.6%, 30.5% and 45.9% for the CHD, CeVD, and PAD cohorts, respectively. The MRCDM, applying the SMART-REACH equation, predicted a CI of recurrent CVD of 37.2%, 25.3%, and 44.9% for the CHD, CeVD, and PAD cohorts, respectively.

CONCLUSIONS: MRCDM predictions are similar to the outcomes from the Extended SMART risk score calculator, with a variation of 2-8%.