Identification of ProliferAtive Diabetic REtinopathy to Asymptomatic Coronary Heart Disease in Chinese T2D Individuals—The IPAD Reach Study

Abstract

Aim: Substantial percentage of patients with T2D have asymptomatic Coronary Heart disease (CHD). To explore identification of PDR to asymptomatic CHD. We reported the baseline data from this IPAD reach group study, a China retrospective cohort study on clinical predictors of asymptomatic CHD in type 2 diabetes. Method: T2D individuals (211non-DR (NDR) and 140 proliferative DR (PDR)) from a national diabetes center in China. The area under the receiver operating characteristic curve (AUC) were created. Discrimination and reclassification were used to assess the value of addition of PDR to the base model. Results: Investigation included 211 NDR and 140 PDR. With the model estimating risk of asymptomatic CHD based on UKPDS engine, the AUC analysis improved from 0.583 (95% CI, 0.51-0.66) to 0.697 (95% CI, 0.641- 0.752) in the model without PDR and with PDR. The addition of PDR to a base model (8 traditional risk factors) to identify asymptomatic CHD increased the C statistic from 0.746 (95% CI, 0.681-0.811) to 0.762 (95% CI, 0.699-0.825; P=0.73). With the addition of PDR to the base model, there was a continuous net reclassification indexes (NRI) of 5.9% (95% CI, 1.4%-10.2%, p=0.017) for asymptomatic CHD. The absolute integrated discrimination index (IDI) was 0.004 (p= 0.02), with a relative IDI of 10.4%. Conclusions: The improvement in identification of asymptomatic CHD, compared with traditional risk factors, demonstrates that PDR could identify cardiovascular risk stratification in Chinese diabetic individuals. Follow-up of this cohort will provide reliable information on asymptomatic CHD risk. Disclosure J. Zhou: None. J. Yang: None.