Читать книгу Diabetic Retinopathy and Cardiovascular Disease - Группа авторов - Страница 22

The implementation of cardiovascular risk scores and risk-based therapeutic decisions should be evaluated in interventional trials to ascertain whether their use actually alters clinical decision making and improves patient outcomes. A 2017 Cochrane review synthesised trials investigating cardiovascular risk scores [34]. It was not specific to patients with diabetes. Forty-one randomised control trials were identified. The review concluded that there was uncertainty as to whether use of risk scores altered cardiovascular event rates but there was some weak evidence that they may lead to more favourable risk factor levels and increased prescribing of preventative medications. Among patients with type 2 diabetes specifically, a systematic review found that only the Framingham Risk Score has been subjected to intervention trials [31]. Two out of the three of these trials had found some benefit with regard to the prescription of preventative medications, but no significant effect was observed on risk of cardiovascular events [35, 36]. Despite the integration of cardiovascular risk prediction models into diabetes guidelines, there is still inadequate clinical evidence to validate their role.