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We compared the effects of CVD and LLA on the risk of mortality in people with type 1 diabetes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We used pooled data from the SURGENE, GENEDIAB, and GENESIS prospective cohorts. Data were divided into: 1\/absence of CVD (myocardial infarction and\/or stroke) nor LLA, 2\/history of CVD alone without LLA, 3\/LLA alone without CVD or 4\/both conditions at baseline. Participants with baseline history of peripheral artery disease were excluded from groups 1 and 2. The study endpoint was any death occurring during follow-up, regardless of the causes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Among 1169 participants (male 55%, age 40\u2009\u00b1\u200913\u00a0years, diabetes duration 23\u2009\u00b1\u200911\u00a0years), CVD, LLA or both were present at baseline in 49 (4.2%), 62 (5.3%) and 20 (1.7%) subjects, respectively. All-cause death occurred in 304 (26%) participants during 17-year follow-up, corresponding to 18,426 person-years and an incidence rate of 16 (95%CI, 15\u201318) per 1000 person-years. The risk of death increased in individuals with baseline history of CVD (adjusted HR 2.00 [95% CI 1.34\u20133.01], p\u2009=\u20090.0008) or LLA (2.26 [1.56\u20133.28], p\u2009&lt;\u20090.0001), <jats:italic>versus<\/jats:italic> no condition, with an additive effect in people with both conditions (5.32 [3.14\u20139.00], p\u2009&lt;\u20090.0001). No incremental risk of death was observed in people with CVD <jats:italic>versus<\/jats:italic> LLA (0.87 [0.54\u20131.41]). Compared with no condition, CVD and LLA were similarly associated with reduced life expectancy during follow-up: 2.79 (95% CI 1.26\u20134.32) and 3.38 (1.87\u20134.88) years, respectively. Combined conditions expose to 7.04 (4.76\u20139.31) less years of life expectancy (all p\u2009&lt;\u20090.0001).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>CVD and LLA conferred a similar burden regarding mortality in type 1 diabetes population. Our findings encourage a careful consideration of people with type 1 diabetes and LLA as usually recommended for those with CVD, in terms of management of risk factors, treatments and prevention.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12933-022-01487-8","type":"journal-article","created":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T12:02:44Z","timestamp":1652097764000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Differential prognostic burden of cardiovascular disease and lower-limb amputation on the risk of all-cause death in people with long-standing type 1 diabetes"],"prefix":"10.1186","volume":"21","author":[{"given":"Marion","family":"Camoin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilberto","family":"Velho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre-Jean","family":"Saulnier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis","family":"Potier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yawa","family":"Abouleka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlyne","family":"Carpentier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Severine","family":"Dubois","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Larroumet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Rigalleau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elise","family":"Gand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Bourron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lyse","family":"Bordier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Scheen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samy","family":"Hadjadj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronan","family":"Roussel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Marre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamel","family":"Mohammedi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,5,9]]},"reference":[{"issue":"6","key":"1487_CR1","doi-asserted-by":"publisher","first-page":"1018","DOI":"10.2337\/dc15-2308","volume":"39","author":"JL Harding","year":"2016","unstructured":"Harding JL, Shaw JE, Peeters A, Davidson S, Magliano DJ. 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Circulation. 2019;139(6):730\u201343.","journal-title":"Circulation"}],"container-title":["Cardiovascular Diabetology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12933-022-01487-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12933-022-01487-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12933-022-01487-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T12:02:47Z","timestamp":1652097767000},"score":1,"resource":{"primary":{"URL":"https:\/\/cardiab.biomedcentral.com\/articles\/10.1186\/s12933-022-01487-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,9]]},"references-count":41,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["1487"],"URL":"https:\/\/doi.org\/10.1186\/s12933-022-01487-8","relation":{},"ISSN":["1475-2840"],"issn-type":[{"value":"1475-2840","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,9]]},"assertion":[{"value":"3 February 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 February 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 May 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The Ethics Committee of Angers University Hospital (Angers, France) approved the SURGENE, GENEDIAB and GENESIS protocols, and all participants provided written informed consent.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"L.P. reports personal fees and non-financial support from Sanofi, Novo Nordisk, Eli Lilly and MSD. VR had grants from the Servier Diabetes institute, Roche, and Merck Lipha Sant\u00e9. O.B. reports personal fees and non-financial support from MSD and Sanofi. L.B. reports personal fees and non-financial support from Astra Zeneca, Bayer, BD, BMS,\u00a0Boerhinger\u00a0Ingelheim,\u00a0MSD, Novartis, Lilly, Novo\u00a0Nordisk, Roche, and Sanofi. AS has received lecturer\/advisor fees from AstraZeneca, Boehringer Ingelheim, Eli Lilly, Janssen, Merck Sharp and Dohme, Novartis, NovoNordisk, Sanofi and Servier. SH reports personal fees and non-financial support from Astra Zeneca, grants and personal fees from Bayer, personal fees from Boehringer Ingelheim, grants from Dinno Sant\u00e9, personal fees from Eli Lilly, non-financial support from LVL, personal fees and non-financial support from MSD, personal fees from Novartis, grants from Pierre Fabre Sant\u00e9, personal fees and non-financial support from Sanofi, personal fees and non-financial support from Servier, personal fees from Valbiotis. RR reports research grants from Sanofi, Novo Nordisk, and Diabnext, consulting and speakers\u2019 bureau fees (compensation donated to the nonprofit Foundation APHP for Research) from Sanofi, Novo Nordisk, Eli Lilly, Boehringer-Ingelheim, Mundipharma, Janssen, AstraZeneca, MSD, Medtronic, and Abbott. MM is a consultant for Novo-Nordisk Algerian subsidiary, and has received personal fees from Novo-Nordisk, Merck-Sharp and Dohme, and Eli Lilly. KM reports personal fees or non-financial support from Novo Nordisk, Sanofi, Astra-Zeneca, Eli Lilly, Abbott, Boehringer-Ingelheim and LifeScan. Authors declare no other potential conflict of interest relevant to this article.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"71"}}