Evidence map›Paper›PMID 32277955›Full record

ArticleDiabetes research and clinical practice2020

Risk factors differ by first manifestation of cardiovascular disease in type 1 diabetes.

Rachel G Miller, Trevor J Orchard, Tina Costacou

Abstract read
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In one paragraph

Article in Diabetes research and clinical practice, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

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0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Review
  5. The Remnant Lipoprotein Hypothesis of Diabetes-Associated Cardiovascular Disease.Arteriosclerosis, thrombosis, and vascular biology · 2022
    Review
  6. Article
  7. Review
  8. Observational
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors.

Rachel G MillerDepartment of Epidemiology, University of Pittsburgh, Pittsburgh, PA 15260, United States. Electronic address: MillerR@edc.pitt.edu.
Trevor J OrchardDepartment of Epidemiology, University of Pittsburgh, Pittsburgh, PA 15260, United States.
Tina CostacouDepartment of Epidemiology, University of Pittsburgh, Pittsburgh, PA 15260, United States.

Funding

EPIDEMIOLOGY OF DIABETIC COMPLICATIONS--PHASE IIR01DK034818 · NIDDK · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI COSTACOU, TINA · 1986 to 2019
$5.6M
NIDDK NIH HHS R01 DK034818
6 · The paper itself

Abstract

aimsWe compared risk factors for three CVD manifestations and a composite outcome over 25 years' follow-up in the Pittsburgh Epidemiology of Diabetes Complications (EDC) prospective cohort study of childhood-onset (<17 years) type 1 diabetes (n = 658).

methodsFirst CVD manifestations examined were: (1) major atherosclerotic cardiovascular event (MACE, i.e. CVD death, myocardial infarction, stroke), (2) coronary revascularization, (3) soft coronary artery disease (CAD, i.e. ischemia ECG, angina), and a (4) composite (MACE + revascularization) outcome. Baseline and time-varying mean and current risk factors, including medication use, were assessed, in diabetes duration-adjusted models.

resultsMACE (n = 107) was predicted by ln(albumin excretion rate) (AER, HR = 1.3, p < 0.0001), systolic BP (SBP, HR = 1.03, p < 0.0001), white blood cell count (WBC, HR = 1.2, p < 0.0001), HbA1c (HR = 1.2p = 0.03), LDLc (HR = 1.01, p = 0.03). Soft CAD (n = 91) was predicted by ln(AER) (HR = 1.2, p = 0.004), SBP (HR = 1.03, p = 0.0002), WBC (HR = 1.2, p = 0.0003), HbA1c (HR = 1.2, p = 0.005). Revascularization (n = 38) was predicted by LDLc (HR = 1.03, p < 0.0001), eGFR (HR = 0.98, p = 0.002), HbA1c (HR = 1.3, p = 0.03). Adding revascularization to MACE enhanced the role of LDLc, while diminishing that of HbA1c, compared to MACE alone.

conclusionsImportant risk factor associations may be affected by examining composite CVD outcomes. More research is needed to determine how to best incorporate revascularization into composite CVD definitions.

Indexed as

AdultCardiovascular DiseasesDiabetes ComplicationsDiabetes Mellitus, Type 1FemaleHumansMaleProspective StudiesRisk FactorsYoung AdultCardiovascular disease manifestationsComposite CVD OutcomesCVD Risk FactorsRevascularization

Identifiers

PMID32277955
PMCPMC7269839

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.