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July 26, 2026Cardiovascular DiabetologyOpen Access

High carotid plaque burden in T1D is linked to ~238% greater cardiovascular event risk.

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Why the study?

Cardiovascular risk prediction in type 1 diabetes remains suboptimal, and the prognostic value of subclinical carotid atherosclerosis detected by ultrasound has not been well established in this population.

Does the presence and burden of carotid artery plaques predict future cardiovascular events and mortality in adults with type 1 diabetes without prior cardiovascular disease?

Population

701 adults with type 1 diabetes in primary prevention

Comparison

Carotid plaque presence and burden vs absence of plaques

Design

Cohort study

Follow-up

Mean of 5.85 years

Key result

In adults with type 1 diabetes, a high carotid plaque burden (≥3 plaques) was independently associated with an increased risk of first cardiovascular events (HR 3.38; 95% CI 1.37-8.38).

Authors

CVClara ViñalsICIgnacio CongetCMCamila Milad

Discussion

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Overview

Carotid plaques were associated with higher CVE risk in type 1 diabetes; hypothesis-generating for ultrasound screening utility.

Key Points

  • The aim was to evaluate if carotid atherosclerosis predicts future cardiovascular events and mortality in type 1 diabetes.
  • Cohort study involving adults with type 1 diabetes aged ≥ 40 years or with diabetic kidney disease.
  • Follow-up duration of mean 5.85 years with carotid ultrasound assessments.
  • Kaplan–Meier curves and Cox regression models were used to analyze outcomes.
  • 40.4% of participants had carotid plaques, and 45 cardiovascular events occurred during follow-up.
  • High plaque burden (≥ 3 plaques) was associated with increased risk of cardiovascular events (HR 3.38, 95% CI 1.37–8.38).
  • The presence of any plaque was linked to increased risk for both cardiovascular events and all-cause mortality (HR 3.07, 95% CI 1.71–5.51).

Study Design

Type

Cohort (n=701)

Structured PICO

Does the presence and burden of carotid artery plaques predict future cardiovascular events and mortality in adults with type 1 diabetes without prior cardiovascular disease?

P
Population
701 adults with type 1 diabetes in primary prevention, followed for a mean of 5.85 years.
E
Exposure
Presence and high burden (≥ 3 plaques) of preclinical carotid atherosclerosis detected by carotid ultrasound
C
Comparator
Absence of carotid plaques or lower plaque burden
O
Outcome
First cardiovascular event (CVE)hard clinical

Main Result

Hazard Ratio: 3.38 (95% CI 1.37–8.38)

Preclinical carotid atherosclerosis detected by ultrasound is independently associated with an increased risk of future cardiovascular events and mortality in adults with type 1 diabetes, supporting its use for risk stratification.

Cite This Study

Viñals et al. (2026) conducted a cohort in Type 1 diabetes (n=701). High carotid plaque burden (≥ 3 plaques) vs. No or lower plaque burden was evaluated on First cardiovascular event (CVE) (HR 3.38, 95% CI 1.37-8.38). In adults with type 1 diabetes, a high carotid plaque burden (≥3 plaques) was independently associated with an increased risk of first cardiovascular events (HR 3.38; 95% CI 1.37-8.38).

synapsesocial.com/papers/6a65a501d3aea3239cd773f7https://doi.org/10.1186/s12933-026-03300-2
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