The Steno Type 1 Risk Engine identifies preclinical atherosclerosis better than the ESC/EASD-2019 Guidelines in adult subjects with type 1 diabetes at high-risk

• DOI: 10.2337/figshare.20334726.v2
• Publication Date: 2022-09-08T14:29:54Z
• Authors: Tonet Serés-Noriega; Marga Giménez; Verónica Perea; Laura Boswell; Clara Viñals; Jesús Blanco; Irene Vinagre; Adriana Pané; Enric Esmatjes; Ignacio Conget; Antonio J. Amor
• Keywords: Concordance

<p> </p> <p>Objective: To evaluate the concordance between ESC/EASD-2019 and Steno Type 1 Risk Engine (Steno-Risk) cardiovascular risk scales in persons with type diabetes (T1D) without disease (CVD), to analyze their relationships preclinical atherosclerosis. <p>Research design methods: We consecutively selected patients T1D, CVD, with: ≥40 years, nephropathy, or ≥10 years of evolution another factor. The presence plaque at different carotid segments was determined by ultrasonography. Cardiovascular estimated according groups (moderate/high/very-high) Steno-Risk (<10%, low; 10-20%, moderate; ≥20%, high), as T1D-specific scores. As an exploratory analysis, non-T1D-specific ACC/AHA-2013 pooled cohort equation also evaluated individuals 40-79 years. <p>Results: included 501 (53% males, age 48.8 T1D duration 26.5 41.3% harboring plaques). Concordance poor (kappa= 0.19). A stepped increase plaques category seen (18.4%, 38.2% 64.1%, for low/moderate/high-risk; p trend<0.001), no differences (p=0.130). identified plaques, unlike (AUC=0.691; p<0.001 vs. AUC=0.538; p=0.149; respectively). Finally, polynomial regression models (adjusted lipid parameters cardioprotective treatment), irrespective category, high-risk directly associated atherosclerosis (in moderate/high-risk ESC/EASD-2019: OR 2.91 [1.27-6.72] 5.290 [2.746-10.189], ≥2 Similar results were obtained discordant higher (p<0.001). <p>Conclusions: In patient undergoing primary prevention, seems better recognize comparison ESC/EASD-2019. Notwithstanding, ultrasound could improve categorization risk.