Introduction: Diabetes mellitus (DM) is a major risk factor for cardiovascular (CV) events and coronary
heart disease (CHD). Many algorithms are available to assess CV risk, some of which specific for
diabetics. Most of them, however, can hardly be extrapolated to Mediterranean countries.
Aim of the present study was to analyze CV risk and the incidence of events in a cohort of outpatients
with type 2 DM living in Emilia Romagna.
Methods: Clinical charts in the period 1991-1995 were analyzed. Diabetic patients aged 35-65 and no
history of CV disease were eligible. Global risk was computed according to Framingham, RISKARD,
Progetto Cuore and UKPDS algorithms and compared with the actual rate of events over the following 10
years.
Results: 4337 patients were eligible. An absolute 10-yr rate of 9.8% was observed for CHD. Comparing
patients with and without events, we found a significant (P < 0.05, Mann-Whitney U test) difference in
several “classical” risk factors, plus duration of diabetes and HbA1c. Italian algorithms were more
consistent with the observed data, but an underestimation of CV events was present, especially in
females.
Conclusions: Estimation of CV risk is dependent on the algorithm adopted and on the reference cohort.
The performance of such functions is however low. Functions taking into account variables specific for
diabetes severity should be adopted. The algorithm derived from the present study will be utilized for a
prospective estimation of CV risk in our cohort