Echocardiography and inflammatory biomarkers for predicting mortality and major adverse cardiovascular events in type 1 diabetes
Authors' conclusion
Echocardiography combined with inflammatory biomarkers synergistically identifies individuals with type 1 diabetes, without known cardiovascular disease, who are at high risk of mortality and MACE.
Study context
- Population
- Individuals with T1D without known CVD; 51% male, median age 50 years114 deaths
- Participants
- 876 individuals
- Exposure
- Subclinical LV dysfunction (E/e' or global longitudinal strain (GLS)) combined with elevated inflammatory biomarker (IL-6, suPAR or hsCRP) vs E/e' <8 and non-elevated biomarker
- Outcome
- All-cause mortality and MACE
- Follow-up
- 14.5 years
Methodological detailsCox models adjusted for the 10 Steno T1 Risk Engine variables, C-statistics and net reclassification improvement
- Cox models adjusted for the 10 Steno T1 Risk Engine variables
- C-statistics and net reclassification improvement
Main finding
As reported in the abstract
All-cause mortality
Each group vs E/e' <8, non-elevated IL-6Hazard ratio (95% CI)P value
E/e' 8-13, elevated IL-6
2.5(1.4–4.6)
P < 0.01E/e' ≥13, elevated IL-6
3.4(1.5–7.6)
P < 0.01- Deaths
- 114
- Corresponding HRs for suPAR
- 2.4 (1.2 to 4.7, P < 0.01) and 3.9 (1.8 to 8.5, P < 0.01)
Observational data: associations, not effects.
Further findings
C-statistic for mortality
- Steno T1 Risk Engine alone
- 0.839
- + E/e' and IL6
- 0.887
- + E/e' and suPAR
- 0.868
GLS and MACE
- Findings were similar for GLS and with MACE as the outcome
Original publication
Echocardiography and inflammatory biomarkers for predicting mortality and major adverse cardiovascular events in type 1 diabetes. Cardiovasc Diabetol. Published 3 February 2026. doi:10.
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