{ "abstract": "Background\n\nTo evaluate whether carotid atherosclerosis predicts future cardiovascular events (CVE) and mortality in adults with type 1 diabetes (T1D) in primary prevention.Methods\n\nCohort study in adults with T1D participating in a cardiovascular risk assessment program that included carotid ultrasound. Eligibility criteria included age ≥ 40 years, diabetic kidney disease regardless of age or diabetes duration, or type 1 diabetes duration ≥ 10 years in the presence of at least one additional cardiovascular risk factor.The primary endpoint was the first CVE. A secondary endpoint was a composite of CVE plus all-cause mortality. Carotid plaque burden and outcomes were analyzed using Kaplan-Meier curves and Cox regression models.Results\n\n701 individuals were followed for a mean of 5.85 years (mean age 48.5 years; T1D duration 27 years; 51.9% males). Carotid plaques were identified in 40.4%. During follow-up, 45 CVE occurred (18 coronary artery disease, 14 peripheral artery disease, 6 stroke, 3 heart failure, 4 deaths) along with 5 non-cardiovascular deaths. Event-free survival declined progressively with increasing plaque burden (log-rank p < 0.001). In unadjusted analyses, the presence of any plaque was associated with increased risk of CVE (HR 3.14, 95%C I 1.69-5.84) and of the composite endpoint (HR 3.07, 95% CI 1.71-5.51). After multivariable adjustment for demographic, metabolic, and microvascular factors, a high plaque burden (≥ 3 plaques) remained associated with CVE (HR 3.38, 95% CI 1.37-8.38) and with the composite endpoint (HR 2.64, 95% CI 1.13-6.21).Conclusions\n\nPreclinical carotid atherosclerosis in adults with T1D was independently associated with an increased risk of cardiovascular events and mortality. These findings support the potential role of carotid ultrasound as a complementary tool for cardiovascular risk assessment in individuals with T1D.", "abstract_shown": true, "affiliations": [ "Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Villarroel 170, 08036, Barcelona, Spain. vinals@clinic.cat.", "Fundació Clínic per la recerca biomèdica, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain. vinals@clinic.cat.", "Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Villarroel 170, 08036, Barcelona, Spain.", "Fundació Clínic per la recerca biomèdica, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain.", "Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.", "Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain.", "Endocrinology and Nutrition Department, Hospital Universitari Mútua Terrassa, Barcelona, Spain.", "Endocrinology and Nutrition, Centro Médico Milenium, Gran Vía Santiago Ramón y Cajal 9, 50005, Zaragoza, Spain.", "Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Villarroel 170, 08036, Barcelona, Spain. ajamor@clinic.cat.", "Fundació Clínic per la recerca biomèdica, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain. ajamor@clinic.cat.", "Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. ajamor@clinic.cat.", "Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain. ajamor@clinic.cat." ], "article_type": "research article", "arxiv": null, "author_total": 11, "authors": [ { "affs": [ 0, 1 ], "name": "Clara Viñals", "orcid": "0000-0002-6888-0396" }, { "affs": [ 2, 3, 4 ], "name": "Ignacio Conget" }, { "affs": [ 2 ], "name": "Camila Milad" }, { "affs": [ 2 ], "name": "Montse Granados" }, { "affs": [ 2, 3 ], "name": "Jesús Blanco" }, { "affs": [ 2, 5 ], "name": "Maria Claro" }, { "affs": [ 6 ], "name": "Verónica Perea" }, { "affs": [ 7 ], "name": "Tonet Serés-Noriega" }, { "affs": [ 2, 3 ], "name": "Irene Vinagre" }, { "affs": [ 2, 3, 4 ], "name": "Marga Giménez" }, { "affs": [ 8, 9, 10, 11 ], "name": "Antonio J Amor", "orcid": "0000-0001-9237-0903" } ], "bibtex": "https://research.draconitic.com/paper/8wa4yk0xsef44.bib", "cited_by": 0, "doi": "10.1186/s12933-026-03300-2", "fulltext_url": "https://europepmc.org/articles/PMC13681802", "id": "8wa4yk0xsef44", "issns": [ "1475-2840" ], "landing_url": "https://europepmc.org/article/MED/42897549", "language": "eng", "licence": "CC-BY-NC-ND", "licence_label": "CC BY-NC-ND", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/", "metadata_licence": null, "native_subjects": [ [ "lcc", "RC666-701" ], [ "openalex", "2712|Diabetes, Cardiovascular Risks, and Lipoproteins" ] ], "openalex": "W7170174914", "pdf_url": "https://europepmc.org/articles/PMC13681802?pdf=render", "pmcid": "PMC13681802", "pmid": "42897549", "published": "2026-07-01", "publisher": "BMC", "ris": "https://research.draconitic.com/paper/8wa4yk0xsef44.ris", "sources": [ { "first_seen": "2026-10-30T12:19:41Z", "native_id": "MED:42897549", "source": "europepmc", "url": "https://europepmc.org/article/MED/42897549" }, { "first_seen": "2026-10-30T13:45:32Z", "native_id": "0031a54de9434f76820807e070f1f2a6", "source": "doaj", "url": "https://doi.org/10.1186/s12933-026-03300-2" } ], "subjects": [ { "field": "medicine", "origin": "openalex:2712|Diabetes, Cardiovascular Risks, and Lipoproteins", "subfield": "endocrinology-metabolism" } ], "title": "Preclinical carotid atherosclerosis is independently associated with cardiovascular events and mortality in type 1 diabetes.", "title_text": "Preclinical carotid atherosclerosis is independently associated with cardiovascular events and mortality in type 1 diabetes.", "type": "peer-reviewed", "updated_at": "2026-10-31T14:20:39Z", "url": "https://research.draconitic.com/paper/8wa4yk0xsef44", "venue": "Cardiovascular diabetology", "versions": [] }