{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T04:13:11Z","timestamp":1788495191300,"version":"build-2803163510"},"reference-count":76,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Evidence characterizing major adverse cardiovascular and cerebrovascular (MACCE) risk in adult-onset type 1 diabetes (T1DM), particularly vs. type 2 (T2DM), remains limited, inconsistent, and derived from non-US cohorts. Leveraging a multi-centre US database, we compared long-term MACCE risk between adult-onset T1DM and T2DM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Using TriNetX, adults diagnosed with T1DM or T2DM between 2005 and 2015 were followed through 2025. Cohorts were stratified by age, HbA1c, and non-insulin antihyperglycaemic use. Patients were 1:1 propensity-score matched on demographics and comorbidities, yielding a covariate-balanced comparator subset of T2DM patients. Cumulative 10-year risks of MACCE (stroke, haemorrhage, cardiac arrest, heart failure, myocardial infarction, peripheral vascular events, and revascularization procedures), kidney complications, and all-cause mortality were reported for unmatched and matched cohorts, and strata. At baseline, T1DM patients (n = 36 599) were younger with fewer comorbidities than T2DM patients (n = 1 740 748). 10-year MACCE incidence in T1DM was 5.2%. Upon matching (n = 33 364), risks of MACCE [5.5% vs. 11.3%; risk ratio (RR) 0.48; P &amp;lt; 0.001] and all-cause mortality (7.7% vs. 8.3%; RR 0.92; P = 0.003) were lower in T1DM. This held true upon stratification, except mortality, which was similar between patients prescribed antihyperglycaemics (7.0% vs. 6.5%; RR 1.07; P = 0.45).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Compared with a propensity-matched phenotypically selected T2DM comparator cohort, T1DM was associated with lower 10-year MACCE and modestly lower all-cause mortality risk, suggesting lower relative cardiovascular event burden in newly diagnosed adults. In T2DM, however, antihyperglycaemic therapy mitigated mortality risk, yielding survival comparable to T1DM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwag360","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T11:55:47Z","timestamp":1783598147000},"source":"Crossref","is-referenced-by-count":1,"title":["Long-term major adverse cardiovascular and cerebrovascular event risk in adult-onset type 1 versus type 2 diabetes: a propensity-matched cohort study"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5703-7453","authenticated-orcid":false,"given":"Anagh","family":"Astavans","sequence":"first","affiliation":[{"name":"The Johns Hopkins University School of Medicine , 733 N Broadway, Baltimore, MD 21205 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