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July 26, 2026Cardiovascular DiabetologyOpen Access

High carotid plaque burden in T1D is linked to ~238% greater cardiovascular event risk.

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Why the study?

Does the presence and burden of carotid artery plaques predict future cardiovascular events and mortality in adults with type 1 diabetes without prior cardiovascular disease?

Population

701 adults with type 1 diabetes in primary prevention. Mean age 48.5 years, 51.9% male.

Comparison

Presence and high burden of preclinical carotid… vs Absence of carotid plaques or lower plaque burden

Design

Cohort

Follow-up

mean 5.85 years

Key result

In adults with type 1 diabetes, a high carotid plaque burden (≥3 plaques) was independently associated with an increased risk of first cardiovascular events (HR 3.38; 95% CI 1.37-8.38).

Authors

CVClara ViñalsICIgnacio CongetCMCamila Milad

Discussion

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Overview

Carotid plaques were associated with higher CVE risk in type 1 diabetes; hypothesis-generating for ultrasound screening utility.

Key Points

  • The aim was to evaluate if carotid atherosclerosis predicts future cardiovascular events and mortality in type 1 diabetes.
  • Cohort study involving adults with type 1 diabetes aged ≥ 40 years or with diabetic kidney disease.
  • Follow-up duration of mean 5.85 years with carotid ultrasound assessments.
  • Kaplan–Meier curves and Cox regression models were used to analyze outcomes.
  • 40.4% of participants had carotid plaques, and 45 cardiovascular events occurred during follow-up.
  • High plaque burden (≥ 3 plaques) was associated with increased risk of cardiovascular events (HR 3.38, 95% CI 1.37–8.38).
  • The presence of any plaque was linked to increased risk for both cardiovascular events and all-cause mortality (HR 3.07, 95% CI 1.71–5.51).

Study Design

Type

Cohort (n=701)

Structured PICO

Does the presence and burden of carotid artery plaques predict future cardiovascular events and mortality in adults with type 1 diabetes without prior cardiovascular disease?

P
Population
701 adults with type 1 diabetes in primary prevention, followed for a mean of 5.85 years.
E
Exposure
Presence and high burden (≥ 3 plaques) of preclinical carotid atherosclerosis detected by carotid ultrasound
C
Comparator
Absence of carotid plaques or lower plaque burden
O
Outcome
First cardiovascular event (CVE)hard clinical

Main Result

Hazard Ratio: 3.38 (95% CI 1.37–8.38)

Preclinical carotid atherosclerosis detected by ultrasound is independently associated with an increased risk of future cardiovascular events and mortality in adults with type 1 diabetes, supporting its use for risk stratification.

Cite This Study

Viñals et al. (2026) conducted a cohort in Type 1 diabetes (n=701). High carotid plaque burden (≥ 3 plaques) vs. No or lower plaque burden was evaluated on First cardiovascular event (CVE) (HR 3.38, 95% CI 1.37-8.38). In adults with type 1 diabetes, a high carotid plaque burden (≥3 plaques) was independently associated with an increased risk of first cardiovascular events (HR 3.38; 95% CI 1.37-8.38).

synapsesocial.com/papers/6a65a501d3aea3239cd773f7https://doi.org/10.1186/s12933-026-03300-2
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Carotid Plaques and Type 2 Diabetes as Predictors of Cardiovascular Events and Mortality: Insights from the LitHiR Prospective Cohort Study2026 · 2 citations
  2. 2Comprehensive analysis of risk factors associated with carotid plaque in patients with type 2 diabetes mellitus2025 · 4 citations
  3. 3Factors Involved in the Progression of Preclinical Atherosclerosis in People with Type 1 Diabetes2025
  4. 4Risk Stratification and Coronary Optical Coherence Tomography Findings in Asymptomatic Patients With Type 1 Diabetes Mellitus2025
  5. 5Predicting subclinical atherosclerosis in adults with type 1 diabetes using cardiovascular risk models: a cross‑sectional study from Italy2026