AWARE A novel web application to rapidly assess cardiovascular risk in type 2 diabetes mellitus

Abstract

Aim

To describe the development of the AWARE App, a novel web application for the rapid assessment of cardiovascular risk in Type 2 Diabetes Mellitus (T2DM) patients. We also tested the feasibility of using this App in clinical practice.

Methods

Based on 2019 European Society of Cardiology/European Association for the Study of Diabetes criteria for cardiovascular risk stratification in T2DM, the AWARE App classifies patients into very high (VH_CVR), high (H_CVR) and moderate (M_CVR) cardiovascular risk categories. In this retrospective clinical study, we employed the App to assess the cardiovascular risk of T2DM patients, while also collecting data about current glycaemic control and pharmacological treatment.

Results

2243 T2DM consecutive patients were evaluated. 72.2% of the patients were VH_CVR, 8.9% were H_CVR, 0.8% were M_CVR while 18.2% did not fit into any of the risk categories and were classified as “moderate-to-high” (MH_CVR). Compared with the other groups, patients with VH_CVD were more frequently ≥ 65 years old (68.9%), with a longer disease duration (≥ 10 years [56.8%]), a history of cardiovascular disease (41.4%), organ damage (35.5%) and a higher numbers of cardiovascular risk factors. Patients with MH_CVD generally had disease duration < 10 years (96%), younger age (50–60 years [55%]), no history of cardiovascular disease, no organ damage, and 1–2 cardiovascular risk factors (89%). Novel drugs such as Glucagon Like Peptyde 1 Receptor Agonists or Sodium-Glucose Linked Transporter 2 inhibitors were prescribed only to 26.3% of the patients with VH_CVR and to 24.7% of those with H_CVR. Glycaemic control was unsatisfactory in this patients population (HbA1c 7.5 ± 3.4% [58.7 ± 13.4 mmol/mol]).

Conclusions

The AWARE App proved to be a practical tool for cardiovascular risk stratification of T2DM patients in real-world clinical practice.