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Ambivalence about the selection of cardiovascular risk stratification tools: Evidence in a type 1 diabetes population

Ticiane G Bovi1, Denise Engelbrecht Zantut-Wittmann1, Maria Cândida Ribeiro Parisi1

  • 1Division of Endocrinology, Department of Clinical Medicine, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, CP:13083-887, SP, Brazil.

Diabetes & Metabolic Syndrome
|June 26, 2019
PubMed

Insights

Cardiovascular risk calculators for Type 1 Diabetes show significant differences in patient stratification. The CRSC tool identified most patients as high risk, impacting statin eligibility recommendations compared to the Steno tool.

Area of Science:

  • Endocrinology
  • Cardiology
  • Diabetology

Background:

  • Cardiovascular disease (CVD) is a leading cause of death in people with diabetes.
  • Limited tools exist for assessing cardiovascular risk (CVR) in Type 1 Diabetes (T1D) patients.
  • Existing CVR tools show divergence in risk stratification and treatment recommendations.

Purpose of the Study:

  • To compare the risk stratification of two CVR tools in T1D patients.
  • To evaluate the impact of differing risk assessments on statin eligibility.
  • To identify discrepancies between the Steno Type 1 Risk Engine and the Cardiovascular Risk Stratification Calculator (CRSC).

Main Methods:

  • A cross-sectional study involving 104 T1D patients (aged 18-40).
  • Utilized the Steno Type 1 Risk Engine and the CRSC for 10-year cardiovascular event risk assessment.
  • Analyzed differences in risk stratification and statin eligibility between the two tools.

Main Results:

  • Significant divergence in CVR stratification between the Steno and CRSC tools.
  • CRSC classified 65.82% of patients as intermediate or high risk, whereas Steno classified them as low risk.
  • Discrepancies in statin eligibility were noted based on the risk stratification from each tool.

Conclusions:

  • The Steno and CRSC tools provide divergent CVR assessments for T1D patients.
  • CRSC identified a majority of the sample as high risk, leading to different statin prescription recommendations compared to Steno.
  • The choice of CVR tool significantly impacts clinical decisions, particularly regarding statin use in T1D.
Abstract

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