The study protocol was approved by our hospital ethics committee (Parc Taulí Research Ethics Committee) and was conducted in accordance with the Declaration of Helsinki. Exclusion criteria included the following: i) presence of previous clinical CVD (CAD, cerebrovascular disease or peripheral artery disease) based on clinical registers, previous personal history of CVD and/or the presence of suggestive symptoms, ii) abnormal resting ECG, iii) any other acute/chronic condition associated with an inflammatory response (e.g., acute or chronic inflammatory or infectious diseases), iv) use of anti-inflammatory drugs in the previous 6 months, v) malignant disease in the previous 5 years (except basal cell carcinoma), vi) hospitalization in the previous 2 months, vii) arrhythmia (other than atrial premature complex), and viii) pregnancy. T1DM was defined as an onset of diabetes before the age of 36 years and undetectable fasting levels of serum C-peptide (<0.6 ng/mL). Patients were consecutively recruited from our outpatient clinic from November 2008 to February 2014. One hundred and seventy-nine patients aged 18–65 years, with T1DM and without established CVD were included in the study. Accordingly, the Scientific Statement from the American Heart Association and the American Diabetes Association on CVD points to the need for novel risk-estimation tools for better prediction of cardiovascular events in T1DM and suggests the use of models specifically obtained from T1DM cohorts, such as the Steno Type 1 Risk Engine (ST1RE).Īgainst this background, the aims of the present study were to assess the relationship between the ST1RE and preclinical atherosclerosis measured as arterial stiffness, and to identify potential cut-off points of interest in clinical practice. However, neither general (Framingham Risk Score) nor T2DM (UKPDS Risk Engine) risk algorithms are sufficiently robust for risk prediction in T1DM. Several risk scores have been developed to predict CVD both in the general population and specifically in patients with T2DM. However, prospective studies assessing the prognostic value of aortic pulse wave velocity (aPWV), a marker of arterial stiffness, in subjects with T1DM are lacking. Arterial stiffness predicts cardiovascular events independently of classical cardiovascular risk factors in several populations, and its estimation has been demonstrated to improve cardiovascular risk prediction beyond the Framingham Risk Score. Īrterial stiffness is an early indicator of arteriosclerosis and vascular damage and, accordingly, it´s analysis could provide insights into arteriosclerotic mechanisms long before any cardiovascular event occurs. Moreover, T1DM causes a life expectancy loss of about 11 years for men and 13 years for women, with the largest percentage of the estimated loss in life expectancy related to ischemic heart disease (up to one-third). Indeed, the relative risk of death from CAD in T1DM can be ten times greater than that in the non-diabetic population, especially in women, and it is even greater than the relative risk in type 2 diabetes (T2DM). The funders had no role in the study design, data collection and analysis, decision to publish or preparation of the manuscript.Ĭompeting interests: The authors have declared that no competing interests exist.Ĭardiovascular disease (CVD) is the leading cause of death in patients with type 1 diabetes mellitus (T1DM), with coronary artery disease (CAD) as the principal manifestation. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: All relevant data are within the manuscript and its Supporting Information files.įunding: Financial support was provided through the Fondo de Investigación Sanitaria (FIS) PI09/01360 (PI: JMCG), PI12/00954 (PI: JMCG) and PI15/00567 (PI: JMCG) as part of the National R+D+I (2008-2011) and was co-financed by the Instituto de Salud Carlos III - General Evaluation Branch (Spanish Ministry of Economy and Competitiveness) and the European Regional Development Fund (ERDF). Received: MaAccepted: JPublished: September 4, 2019Ĭopyright: © 2019 Llauradó et al. PLoS ONE 14(9):Įditor: Petter Bjornstad, University of Colorado Denver School of Medicine, UNITED STATES (2019) Arterial stiffness is highly correlated with the scores obtained from the Steno Type 1 Risk Engine in subjects with T1DM. Citation: Llauradó G, Cano A, Albert L, Ballesta S, Mazarico I, Luchtenberg M-F, et al.
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