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Risk Factors for Cardiovascular Disease in Type 1 Diabetes
Open accessAbstract
Risk factors for cardiovascular disease (CVD) are well-established in type 2 but not type 1 diabetes (T1DM). We assessed risk factors in the long-term (mean 27 years) follow-up of the Diabetes Control and Complications Trial (DCCT) cohort with T1DM. Cox proportional hazards multivariate models assessed the association of traditional and novel risk factors, including HbA1c, with major atherosclerotic cardiovascular events (MACE) (fatal or nonfatal myocardial infarction [MI] or stroke) and any-CVD (MACE plus confirmed angina, silent MI, revascularization, or congestive heart failure). Age and mean HbA1c were strongly associated with any-CVD and with MACE. For each percentage point increase in mean HbA1c, the risk for any-CVD and for MACE increased by 31 and 42%, respectively. CVD and MACE were associated with seven other conventional factors, such as blood pressure, lipids, and lack of ACE inhibitor use, but not with sex. The areas under the receiver operating characteristics curves for the association of age and HbA1c, taken together with any-CVD and for MACE, were 0.70 and 0.77, respectively, and for the final models, including all significant risk factors, were 0.75 and 0.82. Although many conventional CVD risk factors apply in T1DM, hyperglycemia is an important risk factor second only to age.
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“Furthermore, several studies, including the DCCT/EDIC, have established pulse rate as an independent risk factor for cardiovascular outcomes and mortality [23, 25–28].”
From Cardiovascular autonomic neuropathy defined by indices of heart rate variability is associated with cardiovascular disease: a longitudinal cohort study of participants with type 1 diabetes (2025) · cites this paper as [23]
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Sorted by citations
Lipshultz, S. E., Law, Y. M., Asante‐Korang, A., Austin, E. D., Dipchand, A. I., Everitt, M. D., Hsu, D. T., Lin, K. Y., Price, J. F., Wilkinson, J. D., et al. (2019) · Circulation · doi:10.1161/cir.0000000000000682 · Cited by 422
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Metadata
- Authors
- The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Research Group
- Corresponding author
- The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Research Group
- Venue
- Diabetes
- Publisher
- American Diabetes Association
- Published
- 2016-02-19
- Volume
- 65
- Issue
- 5
- Pages
- 1370-1379
- ISSN
- 0012-1797 (ISSN-L)
- 1939-327X
- PMC
- PMC4839209
- OpenAlex
- W2280350954
- Cited by
- 209
- References
- 50
- Citations by year
- 2026: 11 · 2025: 20 · 2024: 20 · 2023: 24 · 2022: 21 · 2021: 26 · 2020: 25 · 2019: 29 · 2018: 10 · 2017: 15 · 2016: 8
- FWCI
- 20.75
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Diabetes (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Disease (U01- DK-094176, U01-DK-094157)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- type 1 diabetes, cardiovascular disease, cardiovascular risk factors, HbA1c, hyperglycemia, age, myocardial infarction, stroke, congestive heart failure, ACE inhibitors, blood pressure, lipids
- MeSH terms
- Adolescent, Adult, Aging, Canada, Cardiovascular Diseases, Combined Modality Therapy, Cross-Sectional Studies, Diabetes Mellitus, Type 1, Diabetic Angiopathies, Female, Glycated Hemoglobin, Humans, Hyperglycemia, Longitudinal Studies, Male, Models, Cardiovascular, Risk Factors, United States, Cohort Studies, Incidence, Prevalence, Survival Analysis, Randomized Controlled Trials as Topic, Young Adult, Diabetic Cardiomyopathies
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