UKPDS Cardiac Risk Calculator

Assesses risk of coronary heart disease in patients diagnosed with diabetes.

There is more information about this CHD risk stratifying method in the text below the form.


The UKPDS cardiac risk calculator was developed to help with stratification of diabetic patients at risk of suffering from coronary heart disease.

This detection model was created based on the UK Prospective Diabetes Study and contains clinical variables such as hemoglobin A1c, systolic blood pressure or cholesterol.


Diabetic patients are in general at a higher risk of developing cardiovascular disease.

The UKPDS cardiac risk model predicts risk of non-fatal and fatal coronary heart disease and stratifies patients in the following three risk categories:

UKPDS cardiac risk score CHD Risk Probability of developing CHD in next 10 years
>31 High Greater than 30%
18 - 31 Elevated 15 to 30%
<18 Average Less than 15%

1

Gender

2

Patient age

3

Diabetes duration

4

Smoking status

5

Hemoglobin A1c

6

Systolic blood pressure in mmHg

7

Total cholesterol/HDL

8

Urine microalbumin in mcg/min

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Steps on how to print your input & results:

1. Fill in the calculator/tool with your values and/or your answer choices and press Calculate.

2. Then you can click on the Print button to open a PDF in a separate window with the inputs and results. You can further save the PDF or print it.

Please note that once you have closed the PDF you need to click on the Calculate button before you try opening it again, otherwise the input and/or results may not appear in the pdf.


 

The method explained

This is a coronary heart disease predictor (10-year risk) that was built based on data from the UK Prospective Diabetes Study and is addressed to patients diagnosed with type 2 diabetes.

These patients are deemed to have a three times higher risk of cardiovascular disease than general population.

New guidelines recommend that, when it comes to stratifying heart disease risk, diabetes patients be treated similarly to patients with previous cardiovascular events.

The 8 items accounted for in the UKPDS cardiac risk are described in the table below:

UKPDS cardiac risk item Answers (points)
Gender Is used to weight differently the age factor as men have a higher risk of developing CVDs.
Age Less than 60 years: male (6), female (0);
Between 60 and 74 years: male (20), female (9);
More than 74 years: male (41), female (22).
Diabetes duration Less than 5 years (0);
Between 5 and 9 years (2);
More than 9 years (5).
Smoking status* Never (0);
Former (0);
Current (2).
Hemoglobin A1c** Less than 7.0 (0);
Between 7.0 and 7.9 (2);
More than 7.9 (6).
Systolic blood pressure in mmHg Less than 120 (0);
Between 120 and 139 (1);
More than 139 (4).
Total cholesterol/HDL Less than 4.0 (0);
Between 4.0 and 5.9 (6);
More than 5.9 (10).
Urine microalbumin in mcg/min *** Less than 30 (0);
Equal to and more than 30 (1).

*Smoking increases blood pressure, the blood’s tendency to clot and risk of recurrent coronary surgery and decreases levels of HDL (good cholesterol).

**Hemoglobin A1c is associated with blood glucose control and may indicate risk of increased arterial diameter and thickness.

***Excretion of albumin in the urine is considered an early marker of cardiac disease. Microalbuminuria is highly prevalent in hypertensive and diabetic patients.

Patients over 40 with high LDL cholesterol (higher than 100 mg/dL) are prescribed statins to reduce cardiac risk but in some cases, medication is unnecessary because there are no other risk factors. By using stratifying tools such as this one clinicians can customize risk management.

By comparison to the Framingham CHD risk score, the UKPDS has similar sensitivity but was found to perform slightly better.

 

Result interpretation

Diabetic patients are stratified in three categories, based on risk of non-fatal and fatal coronary heart disease:

UKPDS cardiac risk score CHD Risk Probability of developing CHD in next 10 years
>31 High Greater than 30%
18 - 31 Elevated 15 to 30%
<18 Average Less than 15%
 

About the study

The UKPDS cardiac risk model was developed by Christianson et al. in 2006 following a retrospective study that used the United Kingdom Prospective Diabetes Study (UKPDS) risk equation.

The study involved 535 patients diagnosed with type 2 diabetes, 400 in derivation cohort and 135 in validation cohort.

Multivariable linear regression was used to formulate prediction equations for 10-year CHD risk. 8 independent variables remained in the model and cut off points were selected whilst making sure that:

■ The number of patients with total agreement between the model and UKPDS equation, was maximised.

■ Overestimation or underestimation of patient risk by 2 risk categories is avoided.

■ The model rather overestimates than underestimates risk of cardiovascular disease.

In the derivation cohort, 82% agreement with the UKPDS equation was obtained, in 11% risk was overestimated and in 7% underestimated. Similar results were obtained in the validation cohort.

The new UKPDS cardiac risk model facilitates prediction of coronary risk based on individual risk factors.

 

Original source

Christianson TJ, Bryant SC, Weymiller AJ, Smith SA, Montori VM. A pen-and-paper coronary risk estimator for office use with patients with type 2 diabetes. Mayo Clin Proc. 2006; 81(5):632-6.

Other references

1. Davis WA, Colagiuri S, Davis TME. Comparison of the Framingham and United Kingdom Prospective Diabetes Study cardiovascular risk equations in Australian patients with type 2 diabetes from the Fremantle Diabetes Study. Med J. 2009; 190 (4): 180-184.

2. Wilson PW, D'Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation. 1998; 97(18):1837-47.


App Version: 1.0.1

Coded By: MDApp

Specialty: Cardiology

System: Cardiovascular

Objective: Risk Stratification

Type: Calculator

No. Of Items: 8

Year Of Study: 2006

Article By: Denise Nedea

Published On: June 10, 2017 · 02:25 PM

Last Checked: June 10, 2017

Next Review: June 10, 2018