Use of the Steno T1 Risk Engine Identifies Preclinical Atherosclerosis Better Than Use of ESC/EASD-2019 in Adult Subjects With Type 1 Diabetes at High Risk Article Swipe
Tonet Serés‐Noriega
,
Marga Giménez
,
Verónica Perea
,
Laura Boswell
,
Clara Viñals
,
Jesús Blanco
,
Irene Vinagre
,
Adriana Pané
,
Enric Esmatjes
,
Ignacio Conget
,
Antonio J. Amor
·
YOU?
·
· 2022
· Open Access
·
· DOI: https://doi.org/10.2337/dc22-0118
YOU?
·
· 2022
· Open Access
·
· DOI: https://doi.org/10.2337/dc22-0118
OBJECTIVE To evaluate the concordance between the 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD (ESC/EASD-2019) and the Steno T1 Risk Engine (Steno-Risk) cardiovascular risk scales for individuals with type 1 diabetes (T1D) without cardiovascular disease (CVD) and to analyze the relationships of their use with identification of preclinical atherosclerosis. RESEARCH DESIGN AND METHODS We consecutively selected patients with T1D, without CVD, age ≥40 years, with nephropathy, and/or with ≥10 years of T1D evolution with another risk factor. The presence of plaque at different carotid segments was determined by ultrasonography. Cardiovascular risk was estimated in accord with ESC/EASD-2019 risk groups (moderate/high/very high) and the Steno-Risk (<10%, low; 10–20%, moderate; ≥20%, high), as T1D-specific scores. In an exploratory analysis, we also evaluated the non-T1D-specific 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk (ACC/AHA-2013) pooled cohort equation for individuals between 40 and 79 years of age. RESULTS We included 501 patients (53% men, mean age 48.8 years, median T1D duration 26.5 years, 41.3% harboring plaques). Concordance between T1D-specific scales was poor (κ = 0.19). A stepped increase in the presence of plaques according to Steno-Risk category was seen (18.4%, 38.2%, and 64.1%, for low, moderate, and high risk, respectively; P for trend <0.001), with no differences according to ESC/EASD-2019 (P = 0.130). Steno-Risk identified individuals with plaques, unlike ESC/EASD-2019 (area under the curve [AUC] 0.691, P < 0.001, vs. AUC 0.538, P = 0.149). Finally, in polynomial regression models (with adjustment for lipid parameters and cardioprotective treatment), irrespective of the ESC/EASD-2019 category, high risk by Steno-Risk was directly associated with atherosclerosis (in moderate/high-risk by ESC/EASD-2019 odds ratio 2.91 [95% CI 1.27–6.72] and 4.94 [2.35–10.40] for the presence of plaque and two or more plaques). Similar results were obtained with discordant higher Steno-Risk versus ACC/AHA-2013 (P < 0.001). CONCLUSIONS Among T1D patients undergoing primary prevention, use of Steno-Risk seems to result in better recognition of individuals with atherosclerosis in comparison with ESC/EASD-2019. Notwithstanding, carotid ultrasound could improve the categorization of cardiovascular risk.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.2337/dc22-0118
- https://diabetesjournals.org/care/article-pdf/45/10/2412/688735/dc220118.pdf
- OA Status
- bronze
- Cited By
- 31
- References
- 44
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4292458098
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4292458098Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.2337/dc22-0118Digital Object Identifier
- Title
-
Use of the Steno T1 Risk Engine Identifies Preclinical Atherosclerosis Better Than Use of ESC/EASD-2019 in Adult Subjects With Type 1 Diabetes at High RiskWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2022Year of publication
- Publication date
-
2022-08-09Full publication date if available
- Authors
-
Tonet Serés‐Noriega, Marga Giménez, Verónica Perea, Laura Boswell, Clara Viñals, Jesús Blanco, Irene Vinagre, Adriana Pané, Enric Esmatjes, Ignacio Conget, Antonio J. AmorList of authors in order
- Landing page
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https://doi.org/10.2337/dc22-0118Publisher landing page
- PDF URL
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https://diabetesjournals.org/care/article-pdf/45/10/2412/688735/dc220118.pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
bronzeOpen access status per OpenAlex
- OA URL
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https://diabetesjournals.org/care/article-pdf/45/10/2412/688735/dc220118.pdfDirect OA link when available
- Concepts
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Medicine, Diabetes mellitus, Concordance, Internal medicine, Risk factor, Type 1 diabetes, Cohort, Type 2 diabetes, EndocrinologyTop concepts (fields/topics) attached by OpenAlex
- Cited by
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31Total citation count in OpenAlex
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2025: 13, 2024: 8, 2023: 10Per-year citation counts (last 5 years)
- References (count)
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44Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.for | 33, 143, 198, 206, 247, 280 |
| abstract_inverted_index.the | 3, 6, 20, 24, 47, 110, 128, 134, 184, 227, 255, 281, 332 |
| abstract_inverted_index.two | 286 |
| abstract_inverted_index.use | 51, 310 |
| abstract_inverted_index.vs. | 234 |
| abstract_inverted_index.was | 93, 99, 175, 192, 262 |
| abstract_inverted_index.(53% | 157 |
| abstract_inverted_index.2.91 | 273 |
| abstract_inverted_index.2013 | 130 |
| abstract_inverted_index.2019 | 7 |
| abstract_inverted_index.26.5 | 166 |
| abstract_inverted_index.4.94 | 278 |
| abstract_inverted_index.48.8 | 161 |
| abstract_inverted_index.CVD, | 68 |
| abstract_inverted_index.EASD | 21 |
| abstract_inverted_index.Risk | 27, 138 |
| abstract_inverted_index.T1D, | 66 |
| abstract_inverted_index.[95% | 274 |
| abstract_inverted_index.age. | 151 |
| abstract_inverted_index.also | 126 |
| abstract_inverted_index.high | 202, 258 |
| abstract_inverted_index.low, | 199 |
| abstract_inverted_index.low; | 113 |
| abstract_inverted_index.mean | 159 |
| abstract_inverted_index.men, | 158 |
| abstract_inverted_index.more | 288 |
| abstract_inverted_index.odds | 271 |
| abstract_inverted_index.poor | 176 |
| abstract_inverted_index.risk | 31, 83, 98, 105, 259 |
| abstract_inverted_index.seen | 193 |
| abstract_inverted_index.type | 36 |
| abstract_inverted_index.were | 292 |
| abstract_inverted_index.with | 19, 35, 52, 65, 72, 75, 81, 103, 209, 221, 265, 294, 321, 325 |
| abstract_inverted_index.(CVD) | 43 |
| abstract_inverted_index.(T1D) | 39 |
| abstract_inverted_index.(area | 225 |
| abstract_inverted_index.(with | 245 |
| abstract_inverted_index.41.3% | 168 |
| abstract_inverted_index.Among | 304 |
| abstract_inverted_index.Steno | 25 |
| abstract_inverted_index.[AUC] | 229 |
| abstract_inverted_index.could | 330 |
| abstract_inverted_index.curve | 228 |
| abstract_inverted_index.high) | 108 |
| abstract_inverted_index.lipid | 248 |
| abstract_inverted_index.ratio | 272 |
| abstract_inverted_index.risk, | 203 |
| abstract_inverted_index.risk. | 336 |
| abstract_inverted_index.seems | 313 |
| abstract_inverted_index.their | 50 |
| abstract_inverted_index.trend | 207 |
| abstract_inverted_index.under | 226 |
| abstract_inverted_index.years | 77, 149 |
| abstract_inverted_index.≥10 | 76 |
| abstract_inverted_index.≥40 | 70 |
| abstract_inverted_index.0.001, | 233 |
| abstract_inverted_index.0.19). | 179 |
| abstract_inverted_index.0.538, | 236 |
| abstract_inverted_index.0.691, | 230 |
| abstract_inverted_index.38.2%, | 195 |
| abstract_inverted_index.64.1%, | 197 |
| abstract_inverted_index.DESIGN | 58 |
| abstract_inverted_index.Engine | 28 |
| abstract_inverted_index.accord | 102 |
| abstract_inverted_index.and/or | 74 |
| abstract_inverted_index.better | 317 |
| abstract_inverted_index.cohort | 141 |
| abstract_inverted_index.groups | 106 |
| abstract_inverted_index.high), | 117 |
| abstract_inverted_index.higher | 296 |
| abstract_inverted_index.median | 163 |
| abstract_inverted_index.models | 244 |
| abstract_inverted_index.plaque | 88, 284 |
| abstract_inverted_index.pooled | 140 |
| abstract_inverted_index.result | 315 |
| abstract_inverted_index.scales | 32, 174 |
| abstract_inverted_index.unlike | 223 |
| abstract_inverted_index.versus | 298 |
| abstract_inverted_index.years, | 71, 162, 167 |
| abstract_inverted_index.(18.4%, | 194 |
| abstract_inverted_index.0.001). | 302 |
| abstract_inverted_index.0.130). | 217 |
| abstract_inverted_index.0.149). | 239 |
| abstract_inverted_index.ACC/AHA | 131 |
| abstract_inverted_index.METHODS | 60 |
| abstract_inverted_index.RESULTS | 152 |
| abstract_inverted_index.Similar | 290 |
| abstract_inverted_index.analyze | 46 |
| abstract_inverted_index.another | 82 |
| abstract_inverted_index.between | 5, 145, 172 |
| abstract_inverted_index.carotid | 91, 328 |
| abstract_inverted_index.disease | 42 |
| abstract_inverted_index.factor. | 84 |
| abstract_inverted_index.improve | 331 |
| abstract_inverted_index.plaques | 187 |
| abstract_inverted_index.primary | 308 |
| abstract_inverted_index.results | 291 |
| abstract_inverted_index.scores. | 120 |
| abstract_inverted_index.stepped | 181 |
| abstract_inverted_index.without | 40, 67 |
| abstract_inverted_index.≥20%, | 116 |
| abstract_inverted_index.&lt; | 232, 301 |
| abstract_inverted_index.Finally, | 240 |
| abstract_inverted_index.RESEARCH | 57 |
| abstract_inverted_index.category | 191 |
| abstract_inverted_index.diabetes | 38 |
| abstract_inverted_index.directly | 263 |
| abstract_inverted_index.diseases | 15 |
| abstract_inverted_index.duration | 165 |
| abstract_inverted_index.equation | 142 |
| abstract_inverted_index.evaluate | 2 |
| abstract_inverted_index.included | 154 |
| abstract_inverted_index.increase | 182 |
| abstract_inverted_index.obtained | 293 |
| abstract_inverted_index.patients | 64, 156, 306 |
| abstract_inverted_index.plaques, | 222 |
| abstract_inverted_index.presence | 86, 185, 282 |
| abstract_inverted_index.segments | 92 |
| abstract_inverted_index.selected | 63 |
| abstract_inverted_index.10–20%, | 114 |
| abstract_inverted_index.Guideline | 132 |
| abstract_inverted_index.OBJECTIVE | 0 |
| abstract_inverted_index.according | 188, 212 |
| abstract_inverted_index.analysis, | 124 |
| abstract_inverted_index.category, | 257 |
| abstract_inverted_index.developed | 16 |
| abstract_inverted_index.diabetes, | 11 |
| abstract_inverted_index.different | 90 |
| abstract_inverted_index.estimated | 100 |
| abstract_inverted_index.evaluated | 127 |
| abstract_inverted_index.evolution | 80 |
| abstract_inverted_index.harboring | 169 |
| abstract_inverted_index.moderate, | 200 |
| abstract_inverted_index.moderate; | 115 |
| abstract_inverted_index.plaques). | 170, 289 |
| abstract_inverted_index.Assessment | 135 |
| abstract_inverted_index.Guidelines | 9 |
| abstract_inverted_index.Steno-Risk | 111, 190, 218, 261, 297, 312 |
| abstract_inverted_index.adjustment | 246 |
| abstract_inverted_index.associated | 264 |
| abstract_inverted_index.comparison | 324 |
| abstract_inverted_index.determined | 94 |
| abstract_inverted_index.discordant | 295 |
| abstract_inverted_index.identified | 219 |
| abstract_inverted_index.parameters | 249 |
| abstract_inverted_index.polynomial | 242 |
| abstract_inverted_index.regression | 243 |
| abstract_inverted_index.ultrasound | 329 |
| abstract_inverted_index.undergoing | 307 |
| abstract_inverted_index.CONCLUSIONS | 303 |
| abstract_inverted_index.Concordance | 171 |
| abstract_inverted_index.concordance | 4 |
| abstract_inverted_index.differences | 211 |
| abstract_inverted_index.exploratory | 123 |
| abstract_inverted_index.individuals | 34, 144, 220, 320 |
| abstract_inverted_index.preclinical | 55 |
| abstract_inverted_index.prevention, | 309 |
| abstract_inverted_index.recognition | 318 |
| abstract_inverted_index.treatment), | 252 |
| abstract_inverted_index.(Steno-Risk) | 29 |
| abstract_inverted_index.1.27–6.72] | 276 |
| abstract_inverted_index.ACC/AHA-2013 | 299 |
| abstract_inverted_index.T1D-specific | 119, 173 |
| abstract_inverted_index.irrespective | 253 |
| abstract_inverted_index.nephropathy, | 73 |
| abstract_inverted_index.(&lt;10%, | 112 |
| abstract_inverted_index.ESC/EASD-2019 | 104, 214, 224, 256, 270 |
| abstract_inverted_index.collaboration | 18 |
| abstract_inverted_index.consecutively | 62 |
| abstract_inverted_index.pre-diabetes, | 12 |
| abstract_inverted_index.relationships | 48 |
| abstract_inverted_index.respectively; | 204 |
| abstract_inverted_index.(ACC/AHA-2013) | 139 |
| abstract_inverted_index.Cardiovascular | 97, 137 |
| abstract_inverted_index.ESC/EASD-2019. | 326 |
| abstract_inverted_index.[2.35–10.40] | 279 |
| abstract_inverted_index.cardiovascular | 14, 30, 41, 335 |
| abstract_inverted_index.categorization | 333 |
| abstract_inverted_index.identification | 53 |
| abstract_inverted_index.&lt;0.001), | 208 |
| abstract_inverted_index.(ESC/EASD-2019) | 22 |
| abstract_inverted_index.atherosclerosis | 266, 322 |
| abstract_inverted_index.Notwithstanding, | 327 |
| abstract_inverted_index.atherosclerosis. | 56 |
| abstract_inverted_index.cardioprotective | 251 |
| abstract_inverted_index.non-T1D-specific | 129 |
| abstract_inverted_index.ultrasonography. | 96 |
| abstract_inverted_index.moderate/high-risk | 268 |
| abstract_inverted_index.(moderate/high/very | 107 |
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| countries_distinct_count | 1 |
| institutions_distinct_count | 11 |
| corresponding_institution_ids | https://openalex.org/I4210115097 |
| sustainable_development_goals[0].id | https://metadata.un.org/sdg/1 |
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| sustainable_development_goals[0].display_name | No poverty |
| citation_normalized_percentile.value | 0.9579551 |
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| citation_normalized_percentile.is_in_top_10_percent | True |