I would like to use HeartScore® with patients who suffer from diabetes; however, HeartScore® does not include diabetes as an independent risk factor. How do I accommodate these patients?
In the European Guidelines on CVD Prevention, it is not recommended to assess risk in patients with diabetes. They have by their lack of glucose control declared themselves at high risk and should therefore be treated with maximum intensity. HeartScore® uses data from the SCORE study and in this study the definition of diabetes varied between the 12 centres who supplied their data. The SCORE group is actively pursuing ways to incorporate diabetes into the model, but it will take some time until this task is fulfilled. 17/ I am considering using HeartScore® but I’m concerned by the fact that the program does not incorporate body mass index as an independent risk factor. The addition of body mass index (BMI) into the model has been tested several times and BMI has been proved to be a very weak risk factor for CVD. Also, the addition of BMI does not improve the predictive ability of the program. 18/ I noticed that the risk predictions in HeartScore® are different from the published SCORE
