Shore AC, et al. - Researchers identified clinically useful markers of risk for cardiovascular (CV) events in patients with type 2 diabetes (T2D) with or without manifest cardiovascular disease (CVD), using a panel of vascular imaging, functional assessments, and biomarkers reflecting different disease mechanisms. In patients with T2D with manifest CVD, markers of inflammation and endothelial stress reflect CV risk. On the other hand, risk for CV events in subjects with T2D without manifest CVD was chiefly linked to atherosclerosis severity.

Methods

• Participants in the study cohort were 936 patients with T2D recruited at four European centers.
• Carotid intima-media thickness and plaque area, ankle-brachial pressure index, arterial stiffness, endothelial function, and circulating biomarkers were studied at baseline.
• CV events were monitored during a 3-year follow-up period.

Results

• According to the findings, the CV event rate in patients with T2D was higher in those with (n=440) vs those without (n=496) manifest CVD at baseline (5.53 vs 2.15/100 life-years, P < 0.0001).
• New CV events in patients with T2D with manifest CVD were related to higher baseline levels of inflammatory biomarkers (interleukin 6, chemokine ligand 3, pentraxin 3, and hs-CRP) and endothelial mitogens (hepatocyte growth factor and vascular endothelial growth factor A).
• On the other hand, CV events in patients with T2D without manifest CVD were related to more severe baseline atherosclerosis (median carotid plaque area 34.5 mm²[16.1–92.2] vs 19.5 mm² [9.5–40.5], P=0.01).
• Findings revealed that conventional risk factors and measurements of arterial stiffness, as well as endothelial reactivity, were not correlated with CV events.