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de Araujo FM, Comim FV, Lamounier RN, Pena NF, Fajardo VC, de Faria RBG, Silva YM, Lauria MW. A comparative study of cardiovascular risk stratification methods in type 1 diabetes mellitus patients. Diabetol Metab Syndr 2024; 16:10. [PMID: 38191429 PMCID: PMC10775617 DOI: 10.1186/s13098-023-01224-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 11/15/2023] [Indexed: 01/10/2024] Open
Abstract
The Steno Diabetes Center Copenhagen developed the Steno T1 Risk Engine (ST1RE) to predict cardiovascular events, encompassing fatal and nonfatal ischemic heart disease, ischemic stroke, heart failure, and peripheral arterial disease in type 1 diabetes mellitus(T1DM).The current study investigated the agreement between ST1RE and the Brazilian Society for Endocrinology and Metabology (SBEM) classification. Participants were included in the study if diagnosed with T1DM and had at least one outpatient visit in 2021. Patients with established cardiovascular disease and chronic kidney disease on dialysis were excluded. Clinical parameters were obtained from medical records, such as age, body mass index (BMI), blood pressure, physical activity, current smoking, microvascular target organ damage, levels of low-density lipoprotein cholesterol, creatinine, glycated hemoglobin (HbA1c), and albuminuria.Overall, 92 patients (38 males and 53 females) with an age median (P25; P75) of 33 years (25.5;42.5), BMI of 24.8 + 4.1 kg/m2, and duration of diabetes (mean ± SD) of 23.4 + 9.5 years were evaluated. There were no differences considering the gender for most analyzed variables, but a higher proportion of women exhibited microvascular complications such as microalbuminuria, macroalbuminuria, and retinopathy. Our results show a weak agreement in the 10-year cardiovascular risk estimation between SBEM and ST1RE classifications. According to SBEM criteria, 72.8% of patients were considered high-risk, while only 15.2% of patients received the same classification using ST1RE. The dissimilarities between these two classifications were also evident when age and gender factors were compared. While 60% of patients under 35 years were classified as high risk according to SBEM criteria, only 1.8% received this stratification risk in the ST1RE classification.The results indicate a low agreement between the 10-year cardiovascular event risk classification by SBEM and the classification by ST1RE for type 1 diabetes patients without established cardiovascular disease.
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Affiliation(s)
| | - Fábio Vasconcellos Comim
- Universidade Federal de Minas Gerais, Rua São Paulo 1755, apt. 1203, Belo Horizonte-MG, 30170-135, Brazil
| | - Rodrigo N Lamounier
- Universidade Federal de Minas Gerais, Rua São Paulo 1755, apt. 1203, Belo Horizonte-MG, 30170-135, Brazil
| | - Natália F Pena
- Universidade Federal de Minas Gerais, Rua São Paulo 1755, apt. 1203, Belo Horizonte-MG, 30170-135, Brazil
| | - Virgínia C Fajardo
- Universidade Federal de Minas Gerais, Rua São Paulo 1755, apt. 1203, Belo Horizonte-MG, 30170-135, Brazil
| | - Regina Bicalho G de Faria
- Universidade Federal de Minas Gerais, Rua São Paulo 1755, apt. 1203, Belo Horizonte-MG, 30170-135, Brazil
| | - Yuri M Silva
- Universidade Federal de Minas Gerais, Rua São Paulo 1755, apt. 1203, Belo Horizonte-MG, 30170-135, Brazil
| | - Márcio Weissheimer Lauria
- Universidade Federal de Minas Gerais, Rua São Paulo 1755, apt. 1203, Belo Horizonte-MG, 30170-135, Brazil.
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