Arterial stiffness and atherosclerosis and incident cardiovascular events and all‐cause mortality in individuals with manifest cardiovascular disease with and without type 2 diabetes
Authors' conclusion
Arterial stiffness and atherosclerosis are independently, but not differentially, related to cardiovascular events and mortality in individuals with manifest cardiovascular disease with and without T2DM. Atherosclerosis explained a larger proportion of the relation between T2DM and outcomes.
Study context
- Population
- Individuals with manifest CVD, UCC-SMART cohortUCC-SMART cohort
- Participants
- 9,465 individuals
- Exposure
- Arterial stiffness and atherosclerosis measures in individuals with vs without T2D
- Outcome
- Cardiovascular events (non-fatal stroke, non-fatal MI, cardiovascular death) and all-cause mortality
- Follow-up
- Median 10.3 years
Methodological detailsCox regression and structural equation models, adjusted for confounders
- Cox regression and structural equation models
- Adjusted for confounders
Main finding
As reported in the abstract
Cardiovascular events and mortality by arterial stiffness and atherosclerosis
- Events: cardiovascular events
- 2087
- Events: deaths
- 2808
- Higher brachial pulse pressure related to cardiovascular events and mortality, with and without T2D
- Hazard ratios (HRs) ≥ 1.09; 95% confidence intervals (CIs) between 1.03 and 1.30
- Lower carotid distensibility coefficient (DC) related to mortality, with and without T2D
- HRs ≥ 1.20; 95% CI between 1.00 and 1.48
- Lower carotid DC related to cardiovascular events only without T2D
- HR 1.34; 95% CI between 1.20 and 1.49
- Carotid and lower extremity atherosclerosis related to cardiovascular events and mortality, with and without T2D
- HRs ≥ 1.52; 95% CI between 1.27 and 2.21
Observational data: associations, not effects.
Further findings
Mediation of the T2D–outcome relation
- Mediated through arterial stiffness (up to)
- 8.1%
- Mediated through atherosclerosis (up to)
- 16.3%
Original publication
Arterial stiffness and atherosclerosis and incident cardiovascular events and all‐cause mortality in individuals with manifest cardiovascular disease with and without type 2 diabetes. Diabet Med. Published 4 July 2025. doi:10.
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