![]() More studies are needed to characterize the clinical and metabolic features of T1D patients that identify those at very high CVD risk, in whom a very aggressive cardioprotective treatment would be justified. Using ESC criteria, a large proportion (45%) of T1D patients without CVD are classified at very high CVD risk however, among them, none of those < 35 years and only 12% of those ≥ 35 years could be confirmed at very high CVD risk by the ST1RE predicting algorithm. When only patients aged ≥ 50 years were considered, there was greater concordance between ESC classification and ST1RE prediction, since as many as 78% of those at high/very high risk according to ESC were confirmed as such also by ST1RE. According to the ESC classification, 92.5% of patients aged 20 years) alone identified few patients (< 30%) among those aged ≥35 years, who were at very high risk according to ESC, in whom this condition was confirmed by ST1RE conversely, the coexistence of two or more of these criteria identified about half of the patients at high/very high risk also according to this predicting algorithm. Men had higher BMI, WC, SBP than women, while no difference was found in HbA1c levels between genders. Patients were stratified in different CVD risk categories according to ESC criteria and the 10-year CVD risk prediction was estimated with ST1RE within each category. MethodsĪ cohort of 575 adults with T1D (272F/303M, mean age 36 ± 12 years) were studied. As accurate CVD risk stratification is essential for an appropriate preventive strategy, we aimed to evaluate the concordance between 2019 European Society of Cardiology (ESC) CVD risk classification and the 10-year CVD risk prediction according to the Steno Type 1 Risk Engine (ST1RE) in adults with T1D. Our model provides an estimate of benefit that may balance the risks associated with use of SGLT2 inhibition in T1D.Patients with type 1 diabetes (T1D) have higher mortality risk compared to the general population this is largely due to increased rates of cardiovascular disease (CVD). Using the Steno T1 CVD and renal risk engine we estimated the risk of CVD and ESKD in persons with T1D with and without treatment with SGLT2i and found a substantial CVD and ESKD risk reduction, especially in the subgroup with albuminuria. For the estimated 5-year risk of ESKD, we found an overall relative risk reduction of 5.3% (5.1,5.4) with up to 7.6% (6.9,8.4) in the subgroup with albuminuria. Similar results were seen for the 10-year risk of CVD. The SGLT2i induced change in the risk variables translated into an overall 5-year CVD relative risk reduction of 6.1% (95%CI 5.9,6.3), with up to 11.1% (10.0,12.2) in the subgroup with albuminuria. The recorded eGFR and albuminuria were changed in accordance with results from the Tandem studies no change in eGFR and mean (SD) %-change in albuminuria of -23.7 (12.9). Individual absolute change in HbA 1c and SBP was simulated as randomly drawn numbers from a normal distribution with mean (standard deviation (SD)) of -3.6 (0.9) mmol/mmol and -1.12 (2.8) mmHg. The effect of SGLT2i was simulated by changing the recorded HbA 1c and systolic blood pressure (SBP) values in accordance with results from the DEPICT studies. The Steno Type 1 Risk Engine was used to calculate 5-year cumulative risks of ESKD and in the subset of 3,284 (89.7%) without previous CVD at baseline, 5- and 10-year cumulative risk of CVD were estimated. The study is based on 3,660 adults with T1D treated from 2001-2016 who fulfilled the inclusion criteria of age 30-75 years and an eGFR >45 ml/min/1.73 m 2. We aimed to estimate the risk of cardiovascular disease (CVD) and end-stage kidney disease (ESKD) in persons with T1D with and without treatment with SGLT2i. Sodium–glucose cotransporter 2 inhibitors (SGLT2i) have beneficial cardiovascular and renal effects in persons with type 2 diabetes but no studies have shown whether this can be demonstrated in type 1 diabetes (T1D).
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |