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Vascular ultrasound for cardiovascular risk stratification in asymptomatic patients with type-2 diabetes

Abstract : Abstract Aims To identify new independent vascular markers to predict cardiovascular events in patients with type-2 diabetes (T2D), and their incremental value compared to the Swedish National Diabetes Register (NDR) risk score. Methods A retrospective cohort study was conducted on 1332 asymptomatic patients with T2D, free from prior CV event, assessed for a cardiovascular work-up, including Duplex ultrasonography to detect plaque on carotid and femoral arteries. The extent of atherosclerosis was rated as atherosclerosis burden score (ABS). Patients were followed up to 5 years and the occurrence of cardiovascular events recorded. Results A total of 82 patients (6.2%) experienced a cardiovascular event, including 34 (2.6%) myocardial infarction, 18 (1.4%) cardiac revascularisation and 17 (1.3%) stroke. The independent determinants of these events were male sex (HR = 1.81 [1.13–2.88], p = 0.013) and ABS ≥ 2 (HR = 1.98 [1.21–3.25], p = 0.007). The NDR risk score performed poorly to predict cardiovascular events (area under the curve = 0.56 [0.49–0.63], p = 0.11), whereas screening for atherosclerotic plaques provided significant incremental prognostic value over the NDR score (model χ2 increase: +231%, p = 0.002). Conclusion Duplex ultrasonography to screen for atherosclerotic plaques improve the estimation of cardiovascular prognosis on top of clinical data and could be routinely used to improve cardiovascular risk stratification.
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https://hal-unilim.archives-ouvertes.fr/hal-03227780
Contributeur : Elisabeth Grelier <>
Soumis le : lundi 17 mai 2021 - 15:43:44
Dernière modification le : jeudi 20 mai 2021 - 11:12:03

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Angeladine Kenne Malaha, Julien Magne, Lucile Jarlan, Katia Mansour, Melissa Ait-Ouatet, et al.. Vascular ultrasound for cardiovascular risk stratification in asymptomatic patients with type-2 diabetes. Primary Care Diabetes, PCDE/Elsevier, 2021, ⟨10.1016/j.pcd.2021.04.006⟩. ⟨hal-03227780⟩

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