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

Bovi, Ticiane Gonçalez; Zantut-Wittmann, Denise Engelbrecht; Parisi, Maria Cândida Ribeiro

doi:10.1016/j.dsx.2019.05.024

Cited by 3 publications

(3 citation statements)

References 24 publications

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“…In particular, the timing for initiating statin therapy needs further investigation. The STENO score could assist in better assessing the CV risk profile in patients with T1D, and in determining the eligibility for statin use [11].…”

Section: Type 1 Diabetes and CV Risk Evaluation: More Precision Neededmentioning

confidence: 99%

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Arterial stiffness in patients with type 1 diabetes and its comparison to cardiovascular risk evaluation tools

Helleputte

Bortel

Verbeke

et al. 2022

Cardiovasc Diabetol

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Background Arterial stiffness is a potential biomarker for cardiovascular disease (CVD) risk in patients with type 1 diabetes (T1D). However, its relation with other CV risk evaluation tools in T1D has not been elucidated yet. This study aimed to evaluate arterial stiffness in T1D patients free from known CVD, and compare it to other CV risk evaluation tools used in T1D. Methods Cross-sectional study in adults with a T1D duration of at least 10 years and without established CVD. Patients were categorized in CVD risk groups based on 2019 European Society of Cardiology (ESC) guidelines, and the STENO T1D risk engine was used to estimate 10-year risk for CV events. Arterial stiffness was evaluated with carotid-femoral pulse wave velocity (cf-PWV). Coronary artery calcium (CAC) score was assessed and carotid ultrasound was performed. Ambulatory 24-h blood pressure and central hemodynamic parameters were evaluated. Data on renal function and diabetic kidney disease was retrieved. Results 54 patients (age: 46 ± 9.5 years; T1D duration: 27 ± 8.8 years) were included. One-fourth of patients showed prematurely increased aortic stiffness based on cf-PWV (24%). Cf-PWV was significantly associated with CAC score, carotid intima-media thickness, central hemodynamic parameters and diabetic kidney disease. Based on STENO, 20 patients (37%) were at low, 20 patients (37%) at moderate, and 14 patients (26%) at high 10-year risk for CV event. Cf-PWV was strongly associated with the STENO score (rs = + 0.81; R2 = 0.566, p < 0.001), increasing with each higher STENO group (p < 0.01). However, cf-PWV was not significantly different between the two CV risk groups (high versus very high) based on ESC criteria, and ESC criteria compared to STENO classified 10 patients more as having > 10% 10-year risk for CV events (n = 44/54; 81.5% versus n = 34/54; 63%). Conclusions This study demonstrated that a substantial proportion of long-standing T1D patients free from known CVD show premature arterial stiffening. Cf-PWV strongly associates with the STENO risk score for future CV events and with cardiovascular imaging and function outcomes, thereby illustrating the clinical importance of arterial stiffness. The data, however, also show considerable heterogeneity in CV risk and differences in risk categorisation between the STENO tool and ESC criteria.There is a need for refinement of CV risk classification in T1D, and future studies should investigate if evaluation of arterial stiffness should be implemented in T1D clinical practice and which patients benefit the most from its assessment.

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Section: Type 1 Diabetes and CV Risk Evaluation: More Precision Neededmentioning

confidence: 99%

“…However, there seems to be substantial heterogeneity in CV risk in T1D [7,8]. Therefore, it is crucial to accurately assess CV risk in patients with T1D and there is growing research interest into CV risk stratification tools [8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Arterial stiffness in patients with type 1 diabetes and its comparison to cardiovascular risk evaluation tools

Helleputte

Bortel

Verbeke

et al. 2022

Cardiovasc Diabetol

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“…Entre las complicaciones crónicas de la DM, las úlceras del pie, también conocidas como pie diabético, y la amputación de las extremidades son las más graves y implican un mayor impacto socioeconómico. Las úlceras del pie tienen una incidencia anual del 2%, siendo que una persona con diabetes presenta un riesgo del 25% de desarrollar úlceras del pie durante toda la vida (10)(11)(12) .…”

Section: Introductionunclassified

Módulo educativo em ambiente virtual de aprendizagem em Diabetes Mellitus

et al. 2020

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Introducción: Los profesionales de enfermería necesitan ser capacitados y cualificados para atender a las personas con diabetes y uno de los aspectos considerado como fundamental para esa capacitación es el conocimiento de los recursos tecnológicos indicados para el desarrollo del proceso de enseñanza-aprendizaje, como informática, internet, hipermedia, multimedia, y las diversas herramientas de interacción y comunicación.Objetivos: Los objetivos de este estudio fueron desarrollar un módulo educativo sobre pie diabético en Ambiente Virtual de Aprendizaje - AVA en la plataforma Moodle para estudiantes de enfermería y someter el programa a la evaluación de los alumnos. Método: Se trata de un estudio descriptivo transversal, realizado con 31 estudiantes. El módulo educativo fue desarrollado como curso distribuido en cuatro capítulos versando sobre pie diabético. Después del curso los alumnos evaluaron el módulo utilizando instrumento validado conteniendo aspectos pedagógicos (contenido, interacción y actividades) y aspecto técnico (calidad de la interfaz) del AVA. Resultados: Las características obtenidas consideradas como favorables al aprendizaje fueron "contenido" (91,6%), "actividades" (85,8%) y "calidad de la interfaz" (89,7%). La característica "interacción" fue la que obtuvo menor índice (52,7%). Conclusión: Considerando la mayoría de las características evaluadas, concluimos que Moodle se mostró una herramienta eficaz de enseñanza. En cuanto a la característica "interacción", es necesario perfeccionar las cuestiones que afectan a las actividades programadas, estas son el foro y chat para propiciar una mayor relación entre los participantes. Introduction: Nursing professionals need to be trained and qualified to care for people with diabetes, where one of the aspects considered as fundamental for this training is the knowledge of the technological resources indicated for the development of the teaching-learning process, such as computer science, internet, hypermedia, multimedia, besides the various tools of interaction and communication.Objective: The objectives of this study were to develop an educational module about diabetic foot in a Virtual Learning Environment – VLE in the Moodle platform for nursing students and to submit the program to the evaluation of the students. Method: It is a cross-sectional descriptive study, carried out with 31 students. The educational module was developed as a course distributed in four chapters dealing with diabetic foot. After the course, the students evaluated the module using a validated instrument containing pedagogical aspects (content, interaction and activities) and technical aspect (interface quality) of VLE. Results: The characteristics that were considered favorable to learning were “content” (91.6%), “activities” (85.8%) and “interface quality” (89.7%). The “interaction” characteristic was the one that obtained the lowest rate (52.7%). Conclusion: By considering most of the evaluated characteristics, we conclude that Moodle has proved to be an effective teaching tool. Regarding the “interaction” characteristic, it is necessary to improve the questions that involve the scheduled activities, such as forum and chat, in order to provide a greater relationship among the participants.

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A Review of Approaches in the Development of Risk Stratification Models for Diabetic Patients at Risk of Vascular Complications

Osop

2022

IFAC-PapersOnLine

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

Cited by 3 publications

References 24 publications

Arterial stiffness in patients with type 1 diabetes and its comparison to cardiovascular risk evaluation tools

Arterial stiffness in patients with type 1 diabetes and its comparison to cardiovascular risk evaluation tools

Módulo educativo em ambiente virtual de aprendizagem em Diabetes Mellitus

A Review of Approaches in the Development of Risk Stratification Models for Diabetic Patients at Risk of Vascular Complications

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