Cardiovascular risk estimation using the steno type 1 risk engine in Brazilian individuals with type 1 diabetes: a multicenter cross-sectional study

Objective To assess the 5- and 10-year Cardiovascular Disease (CVD) risk among Brazilian patients with Type 1 Diabetes (T1D) using the Steno Type 1 Risk Engine (ST1RE), and to evaluate the prevalence of clinical CVD, analyzing traditional and non-traditional risk factors. Material and methods This was a cross-sectional multicenter study conducted in 13 public clinics in 11 Brazilian cities, involving 1,760 patients. The ST1RE was used in patients without previous CVD ( n = 1,300). Results The prevalence of CVD was 2.1%, with ischemic heart disease being the most common. These patients were older, had higher age at T1D diagnosis, and longer diabetes duration when CVD was diagnosed. According to ST1RE 10-year risk, 70.7% were classified as low, 18.0% as moderate, and 11.3% as high risk without differences regarding sex. A lower use of cardioprotective drugs was noted in patients with moderate/high 10-year ST1RE in relation to guidelines recommendations. Higher age at diagnosis, presence of retinopathy, elevated high-sensitivity C-reactive protein, and uric acid levels were associated to moderate/high ST1RE risk. Conclusions Almost 30% of our patients had moderate/high ST1RE risk and were undertreated for CVD risk factors. This highlights the need to establish strategies to improve cardiovascular and diabetes management risk in routine clinical practice.