Predicting subclinical atherosclerosis in adults with type 1 diabetes using cardiovascular risk models: a cross‑sectional study from Italy
Authors' conclusion
In an Italian cohort of asymptomatic T1D adults, T1D-specific risk scores demonstrated a strong discrimination ability for imaging-defined subclinical atherosclerosis. They might help triage asymptomatic individuals who could benefit from targeted cardiovascular imaging in specific settings. Since these tools predict events rather than imaging findings, recalibration and prospective validation against imaging endpoints are needed before using predicted probabilities as absolute risks informing clinical decision-making.
Study context
- Population
- Consecutive T1D adults without history of cardiovascular disease (CVD), secondary centre in Italy; mean age 45 ± 13 years, 52.5% males, median diabetes duration 21 years
- Participants
- 101 adults
- Exposure
- T1D-specific CV risk models for predicting subclinical atherosclerosis
- Outcome
- Composite imaging endpoint:
- Any coronary plaque on coronary computed tomography angiography (CCTA)
- cIMTmax ≥ 1.5 mm
Methodological detailssingle-centre, consecutive patients
- Single-centre
- Consecutive patients
Main finding
As reported in the abstract
| Group | AUC |
|---|---|
| ST1RE | 0.899 |
| Scottish-Swedish | 0.907 |
AUC
- Composite imaging endpoint occurred
- 66/101 (65.4%)
Observational data: associations, not effects.
Further findings
| Outcome | ST1RE | Scottish-Swedish |
|---|---|---|
| Calibration (Brier score) for composite imaging endpoint | ||
| Brier score | 0.126 | 0.128 |
Calibration (Brier score) for composite imaging endpoint
- Apparent calibration acceptable
Components of imaging endpoint
- Coronary plaques
- 55 (54.5%)
- cIMTmax above threshold
- 41 (40.6%)
Original publication
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