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July 23, 2026Journal of Clinical MedicineOpen Access

Coexisting carotid plaques and Type 2 diabetes linked to ~70% higher MACE risk.

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Why the study?

Does the presence of carotid plaques and/or Type 2 diabetes predict cardiovascular events and mortality in a high-cardiometabolic-risk primary prevention cohort?

Population

6138 participants enrolled in the Lithuanian High Cardiovascular Risk primary prevention program without…

Comparison

Presence of carotid plaques and/or Type 2… vs Absence of carotid plaques and/or DM

Design

Cohort

Follow-up

median 6.5 years (IQR 4.5–9.0)

Key result

The presence of both carotid plaques and Type 2 diabetes was associated with the highest risk of major adverse cardiovascular events (HR 1.696; 95% CI 1.346-2.136; p<0.001).

Authors

VDV. DženkevičiūtėTATadas AdomavičiusGTGabrielė Tarutytė

Discussion

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Member takes

Overview

May improve risk stratification in primary prevention; leaves open whether plaques add incremental value beyond DM for guiding therapy.

Key Points

  • The study aims to evaluate the independent and combined impacts of carotid plaques and type 2 diabetes on cardiovascular events and mortality.
  • Prospective cohort study involving 6138 participants from the LitHiR primary prevention program.
  • Participants underwent clinical assessment and carotid ultrasonography to determine plaque presence and diabetes status.
  • Cox proportional hazards models evaluated associations with cardiovascular events and mortality.
  • 16% of participants experienced composite cardiovascular events during a median follow-up of 6.5 years.
  • Higher risk of MACE found in individuals with both diabetes and carotid plaques (HR = 1.696; 95% CI: 1.346–2.136; p < 0.001).
  • Carotid plaques were strongly associated with cardiovascular outcomes, more so than diabetes alone.

Study Design

Type

Cohort (n=6,138)

Structured PICO

Does the presence of carotid plaques and/or Type 2 diabetes predict cardiovascular events and mortality in a high-cardiometabolic-risk primary prevention cohort?

P
Population
6,138 individuals without known cardiovascular disease in a high-cardiometabolic-risk primary prevention program, followed for a median of 6.5 years.
E
Exposure
Presence of carotid plaques and/or Type 2 diabetes mellitus (DM)
C
Comparator
Absence of carotid plaques and/or DM
O
Outcome
Major adverse cardiovascular events (MACE, including non-fatal ischaemic stroke, non-fatal myocardial infarction, and cardiovascular death)composite

Main Result

Hazard Ratio: 1.696 (95% CI 1.346–2.136)

p-value: p=<0.001

In a high-cardiometabolic-risk primary prevention cohort, carotid plaques were independently and more strongly associated with cardiovascular outcomes than diabetes alone, supporting the prognostic value of carotid plaque assessment.

Limitations

  • Findings are associational
  • Applies to a high-risk metabolic syndrome cohort; extrapolation to the general population requires further study

Cite This Study

Dženkevičiūtė et al. (2026) conducted a cohort in High cardiometabolic risk without known cardiovascular disease (n=6,138). Carotid plaques and Type 2 diabetes mellitus vs. Absence of carotid plaques and/or Type 2 diabetes was evaluated on Major adverse cardiovascular events (MACE, including non-fatal ischaemic stroke, non-fatal myocardial infarction, and cardiovascular death) (HR 1.696, 95% CI 1.346-2.136, p=<0.001). The presence of both carotid plaques and Type 2 diabetes was associated with the highest risk of major adverse cardiovascular events (HR 1.696; 95% CI 1.346-2.136; p<0.001).

synapsesocial.com/papers/6a61b056faa9903c5116af73https://doi.org/10.3390/jcm15145695
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