{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:09:15Z","timestamp":1773014955905,"version":"3.50.1"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100004339","name":"Sanofi","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004339","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004752","name":"State Government of Victoria","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004752","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004312","name":"Eli Lilly and Company","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004312","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Heart failure (HF) may develop in type 2 diabetes without prior cardiovascular disease (CVD). This study aimed to identify risk factors that distinguish CVD that presents first as a HF event versus CVD that presents first as an atherosclerotic event (ASCVD), among people with type 2 diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      ORIGIN and REWIND trial participants with type 2 diabetes but free of CVD (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u20096175; 64\u2009\u00b1\u20097\u2009years, 50.1% female) were followed for ~5.8\u2009years for incident CVD presenting first as either a HF event (HF hospitalization or HF death), ASCVD (myocardial infarction, unstable angina, stroke, or revascularization), or other cardiovascular death. Multi\u2010state models characterised event\u2010specific associations of risk factors with each possible first CVD event.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>HF was the first event in 16.8% of 1024 incident CVD cases. Older age, higher BMI, and higher urine albumin:creatinine ratio were more strongly associated with CVD manifesting first as HF, rather than as ASCVD or other cardiovascular death. ASCVD as the first event (65.2% of cases) was more strongly associated with worse LDL\u2010cholesterol and HbA1c. These unique associations of risk factors with HF versus ASCVD translated to variable probabilities of HF as the first CVD event, depending on the clinical profile (32.0% for a profile enriched with HF\u2010specific risk factors versus 5.1% for a profile enriched with ASCVD\u2010specific risk factors).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CVD that presents first as a HF event is common in type 2 diabetes and its risk factors are distinct from those associated with CVD that presents first as an ASCVD event.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.70426","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T08:44:27Z","timestamp":1768293867000},"page":"2308-2316","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prediction of heart failure as the first major cardiovascular disease event in type 2 diabetes"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1315-3463","authenticated-orcid":false,"given":"Julian W.","family":"Sacre","sequence":"first","affiliation":[{"name":"Clinical Diabetes and Epidemiology Baker Heart and Diabetes Institute  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristin","family":"Lundegard","sequence":"additional","affiliation":[{"name":"Clinical and Translational Research Steno Diabetes Center Copenhagen  Herlev Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6139-1197","authenticated-orcid":false,"given":"Kamel","family":"Mohammedi","sequence":"additional","affiliation":[{"name":"INSERM Unit 1034, Biology of Cardiovascular Diseases Bordeaux University Hospital  Bordeaux France"},{"name":"Population Health Research Institute McMaster University and Hamilton Health Sciences  Hamilton Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bendix","family":"Carstensen","sequence":"additional","affiliation":[{"name":"Clinical and Translational Research Steno Diabetes Center Copenhagen  Herlev Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8072-2836","authenticated-orcid":false,"given":"Hertzel C.","family":"Gerstein","sequence":"additional","affiliation":[{"name":"Population Health Research Institute McMaster University and Hamilton Health Sciences  Hamilton Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan E.","family":"Shaw","sequence":"additional","affiliation":[{"name":"Clinical Diabetes and Epidemiology Baker Heart and Diabetes Institute  Melbourne Victoria 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