Prediction of coronary artery disease risk in patients with type 2 diabetes mellitus: a mathematical model
DOI:
https://doi.org/10.26641/2307-0404.2025.2.333436Keywords:
type 2 diabetes mellitus, coronary artery disease, mathematical modelAbstract
Coronary artery disease (CAD) is one of the most prevalent and life-threatening complications in individuals with type 2 diabetes mellitus (T2DM). The aim of this study was to develop a mathematical model for predicting the risk of CAD in patients with T2DM. A total of 242 patients with T2DM, aged 30-80 years, were examined. The following parameters were analyzed: patient age, age at T2DM onset, disease duration, fasting glucose levels, glycated hemoglobin levels, lipid profile parameters, blood pressure, presence of diabetic complications, lifestyle factors, family history, and parental exposure to famine in 1932-1933. The predictive mathematical model for CAD development in T2DM patients was constructed using receiver operating characteristic (ROC) analysis and multiple logistic regression. ROC analysis identified the prognostic value of each of the eight key independent variables, which do not depend on the patient's current health status and can be considered independent at the time of CAD diagnosis. In the second phase of the study, a formula for calculating CAD probability was developed, incorporating the most informative variables with predictive significance. These included the patient’s age, T2DM duration, presence of chronic kidney disease, paternal history of T2DM, maternal famine exposure during pregnancy, rural residence, and patient sex. The developed formula was used to predict CAD risk, and its sensitivity, specificity, and diagnostic performance were evaluated. The model demonstrated high predictive accuracy (AUC=0.792 [0.734–0.842], chi-square =65.1; p<0.001). The probability of CAD development was determined with an accuracy of 72.3%, and the model’s predictive efficiency was 73.6%. The obtained results allowed us to establish statistically significant associations between the studied risk factors and CAD development in T2DM patients. Based on these findings, we have developed a mathematical model for predicting CAD risk in T2DM patients, which can be implemented in clinical practice.
References
Seo DH, Kim M, Suh YJ, Cho Y, Ahn SH, Hong S, et al. Association between age at diagnosis of type 2 diabetes and cardiovascular morbidity and mortality risks: A nationwide population-based study. Diabetes Res Clin Pract. 2024;208:111098. doi: https://doi.org/10.1016/j.diabres.2024.111098
Huang L, Wu P, Zhang Y, Lin Y, Shen X, Zhao F, et al. Relationship between onset age of type 2 diabetes mellitus and vascular complications based on propensity score matching analysis. J Diabetes Investig. 2022;13(6):1062-72. doi: https://doi.org/10.1111/jdi.13763
Kim SM, Lee G, Choi S, Kim K, Jeong SM, Son JS, et al. Association of early-onset diabetes, pre-diabetes, and early glycaemic recovery with the risk of all-cause and cardiovascular mortality. Diabetologia. 2020;63(11):2305-14. doi: https://doi.org/10.1007/s00125-020-05252-y
Mancia G, Fagard R, Narkiewicz K, et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension. J Hypertens. 2013;31(7):1281-9. doi: https://doi.org/10.1097/01.hjh.0000431740.32696.cc
Goodarzi MO, Rotter JI. Genetics insights in the relationship between type 2 diab etes and coronary heart disease. Circ Res. 2020;126(11):1326-40. doi: https://doi.org/10.1161/CIRCRESAHA.120.317103
Ye Y, Han J, Jiang W, Natarajan P, Zhao H. Interactions between enhanced polygenic risk scores and lifestyle for cardiovascular disease, diabetes, and lipid levels. Circulation: Genomic and Precision Medicine. 2021;14(1):e003128. doi: https://doi.org/10.1161/CIRCGEN.120.003128
Polemiti E, Baudry J, Kuxhaus O, Jäger S, Bergmann MM, Weikert C, et al. BMI and BMI change fol-lowing incident type 2 diabetes and risk of microvascular and macrovascular complications: the EPIC-Potsdam study. Diabetologia. 2021;64(5):1084-96. doi: https://doi.org/10.1007/s00125-021-05367-x
Nanayakkara N, Curtis AJ, Heritier S, Gadowski AM, Pavkov ME, Kenealy T, et al. Impact of age at type 2 diabetes mellitus diagnosis on mortality and vascular complications: systematic review and meta-analyses. Diabetologia. 2021;64(2):275-87. doi: https://doi.org/10.1007/s00125-020-05319-w
Sattar N, Rawshani A, Franzén S, Rawshani A, Svensson AM, Rosengren A, et al. Age at diagnosis of type 2 diabetes mellitus and associations with cardiovascular and mortality risks. Circulation. 2019 May 7;139(19):2228-37. doi https://doi.org/10.1161/CIRCULATIONAHA.118.037885
de Jong M, Woodward M, Peters SAE. Duration of diabetes and the risk of major cardiovascular events in women and men: a prospective cohort study of UK biobank participants. Diabetes Res Clin Pract. 2022;188:109899. doi: https://doi.org/10.1016/j.diabres.2022.109899
Huang JX, Liao YF, Li YM. Clinical features and microvascular complications risk factors of early-onset type 2 diabetes mellitus. Curr Med Sci. 2019;39(5):754-8. doi: https://doi.org/10.1007/s11596-019-2102-7
Endothelial Dysfunction and Diabetic Cardio-myopathy. Front Endocrinol. 2022;13:851941. doi: https://doi.org/10.3389/fendo.2022.851941
Saienko YaA, Pysaruk AV, Koshel NM, Mankovskyi BM. [Clinico-demographic characteristics of patients with type 2 diabetes mellitus of different age groups and their relationship with the risk of developing cardiovascular complications]. Endokrynologia. 2024;29(3):240-6. Ukrainian. doi: https://doi.org/10.22141/2224-0439
[All-Ukrainian Association of Cardiologists of Ukraine. Recommendations of the All-Ukrainian As-sociation of Cardiologists of Ukraine on the diagnosis, treatment and prevention of chronic heart failure]. [Internet]. 2024 [cited 2025 Feb 5]. Ukrainian. Available from: https://cardiocongress.org.ua/wp-content/uploads/2024/09/Рекомендації-ХСН-А6-1.pdf
Chronic Kidney Disease in the Older Adult Patient with Diabetes. J Clin Med. 2024;13(2):348. doi: https://doi.org/10.3390/jcm13020348
Saienko YaA, Pysaruk AV, Koshel NM, Mankovskyi BM. [The relationship between chronic kidney disease and cardiovascular pathology in patients with type 2 diabetes of different ages]. Ukrainian J Cardiol. 2024;31(5):21-30. Ukrainian. doi: https://doi.org/10.31928/2664-4479-2024.5.2130
Ye Y, Chen X, Han J, Jiang W, Natarajan P, Zhao H. Interactions Between Enhanced Polygenic Risk Scores and Lifestyle for Cardiovascular Disease, Diabetes, and Lipid Levels. Circulation: Genomic and Precision Medicine. 2021;14(1):e003128. doi: https://doi.org/10.1161/CIRCGEN.120.003128
Vaiserman AM, Khalangot ND, Pisaruk AV, Mekhova LV, Kolyada AK, Kutsenko KY, et al. Predis¬posi-tion to type II diabetes among those residents of Ukraine whose prenatal development coincided with the famine of 1932-1933. Adv Gerontol. 2011;1:362-6. doi: https://doi.org/10.1134/S2079057011040163
Zong JC, Hengjinda P. Early Prediction of Coronary Artery Disease (CAD) by Machine Learning Method – A Comparative Study. J Artif Intell Capsule Netw. 2021;3(1):17-33. doi: https://doi.org/10.1007/s00125-020-05362-7
Hassanzad M, Hajian-Tilaki K. Methods of determining optimal cut-point of diagnostic biomarkers with application of clinical data in ROC analysis: an update review. BMC Med Res Methodol. 2024;24:84. doi: https://doi.org/10.1186/s12874-024-02198-2
Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int. 2024;105(4S):S117-S314. doi: https://doi.org/10.1016/j.kint.2023.10.018
ESC Guidelines on Chronic Coronary Syndromes. Eur Heart J. 2024;45(1):ehae177. doi: https://doi.org/10.1093/eurheartj/ehae177
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Medicni perspektivi
This work is licensed under a Creative Commons Attribution 4.0 International License.
Submitting manuscript to the journal "Medicni perspektivi" the author(s) agree with transferring copyright from the author(s) to publisher (including photos, figures, tables, etc.) editor, reproducing materials of the manuscript in the journal, Internet, translation into other languages, export and import of the issue with the author’s article, spreading without limitation of their period of validity both on the territory of Ukraine and other countries. This and other mutual duties of the author and all co-authors separately and editorial board are secured by written agreement by special form to use the article, the sample of which is presented on the site.
Author signs a written agreement and sends it to Editorial Board simultaneously with submission of the manuscript.
