Currently submitted to: JMIR Cardio
Date Submitted: May 22, 2026
Open Peer Review Period: May 25, 2026 - Jul 20, 2026
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MyHEART-DM Score: A Predictive Screening Risk Scoring Tool for Ischemic Heart Disease Among Malaysian Patients with Type 2 Diabetes Mellitus
ABSTRACT
Background:
Ischemic heart disease (IHD) remains the leading cause of mortality worldwide, with patients with type 2 diabetes mellitus (T2DM) experiencing substantially increased cardiovascular risk.
Objective:
This study aimed to develop and validate the MyHEART-DM Score, a prognostic screening tool for predicting IHD risk among Malaysian patients with T2DM using real-world registry data.
Methods:
A retrospective cohort study was conducted using data from the National Diabetes Registry (NDR) Johor, Malaysia, from 2020 to 2024. Patients were divided into development (2020–2021), internal validation (2022–2023), and external validation (2024) cohorts. Multivariable logistic regression was used to develop the prognostic model, and weighted scores were generated using a shrinkage approach. Model performance was assessed using discrimination and calibration analyses.
Results:
A total of 11,082, 13,068, and 7,613 patients were included in the development, internal validation, and external validation cohorts, respectively. The final MyHEART-DM Score incorporated 15 prognostic variables and demonstrated moderate but consistent discrimination across all cohorts, with area under the receiver operating characteristic curve values of 0.686, 0.694, and 0.687, respectively. Calibration performance was satisfactory, with calibration intercepts close to 0 and slopes close to 1 across all cohorts. The score stratified patients into low (<20), intermediate (20–40), and high-risk (>40) categories, with progressively higher odds of IHD observed across risk groups.
Conclusions:
The MyHEART-DM Score may serve as a practical tool for IHD risk stratification among Malaysian patients with T2DM in primary care settings and may contribute toward achieving Sustainable Development Goal 3 by supporting early detection and prevention of cardiovascular complications among high-risk populations. Further prospective validation and integration into clinical decision support systems are recommended. Clinical Trial: Not applicable.
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