{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T19:25:03Z","timestamp":1769109903716,"version":"3.49.0"},"reference-count":22,"publisher":"American Diabetes Association","issue":"10","license":[{"start":{"date-parts":[[2018,9,20]],"date-time":"2018-09-20T00:00:00Z","timestamp":1537401600000},"content-version":"vor","delay-in-days":52,"URL":"http:\/\/www.diabetesjournals.org\/content\/license"}],"funder":[{"DOI":"10.13039\/501100010767","name":"Innovative Medicines Initiative","doi-asserted-by":"crossref","award":["IMI-2008\/115006"],"award-info":[{"award-number":["IMI-2008\/115006"]}],"id":[{"id":"10.13039\/501100010767","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,10,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>Cardiovascular disease (CVD) risk prediction represents an increasing clinical challenge in the treatment of diabetes. We used a panel of vascular imaging, functional assessments, and biomarkers reflecting different disease mechanisms to identify clinically useful markers of risk for cardiovascular (CV) events in subjects with type 2 diabetes (T2D) with or without manifest CVD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>The study cohort consisted of 936 subjects with T2D recruited at four European centers. Carotid intima-media thickness and plaque area, ankle-brachial pressure index, arterial stiffness, endothelial function, and circulating biomarkers were analyzed at baseline, and CV events were monitored during a 3-year follow-up period.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>The CV event rate in subjects with T2D was higher in those with (n = 440) than in those without (n = 496) manifest CVD at baseline (5.53 vs. 2.15\/100 life-years, P &amp;lt; 0.0001). New CV events in subjects with T2D with manifest CVD were associated with higher baseline levels of inflammatory biomarkers (interleukin 6, chemokine ligand 3, pentraxin 3, and hs-CRP) and endothelial mitogens (hepatocyte growth factor and vascular endothelial growth factor A), whereas CV events in subjects with T2D without manifest CVD were associated with more severe baseline atherosclerosis (median carotid plaque area 30.4 mm2 [16.1\u201392.2] vs. 19.5 mm2 [9.5\u201340.5], P = 0.01). Conventional risk factors, as well as measurements of arterial stiffness and endothelial reactivity, were not associated with CV events.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Our observations demonstrate that markers of inflammation and endothelial stress reflect CV risk in subjects with T2D with manifest CVD, whereas the risk for CV events in subjects with T2D without manifest CVD is primarily related to the severity of atherosclerosis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc18-0185","type":"journal-article","created":{"date-parts":[[2018,7,30]],"date-time":"2018-07-30T18:45:12Z","timestamp":1532976312000},"page":"2212-2219","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":29,"title":["Use of Vascular Assessments and Novel Biomarkers to Predict Cardiovascular Events in Type 2 Diabetes: The SUMMIT VIP Study"],"prefix":"10.2337","volume":"41","author":[{"given":"Angela C.","family":"Shore","sequence":"first","affiliation":[{"name":"Diabetes and Vascular Medicine, University of Exeter Medical School, National Institute for Health Research Exeter Clinical Research Facility, Exeter, U.K."}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8345-3288","authenticated-orcid":false,"given":"Helen M.","family":"Colhoun","sequence":"additional","affiliation":[{"name":"Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, U.K."}]},{"given":"Andrea","family":"Natali","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy"}]},{"given":"Carlo","family":"Palombo","sequence":"additional","affiliation":[{"name":"Department of Surgical, Medical, Molecular, and Critical Area Pathology, University of Pisa, Pisa, Italy"}]},{"given":"Faisel","family":"Khan","sequence":"additional","affiliation":[{"name":"Division of Molecular and Clinical Medicine, University of Dundee, Dundee, U.K."}]},{"given":"Gerd","family":"\u00d6stling","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Malm\u00f6, Lund University, Lund, Sweden"}]},{"given":"Kunihiko","family":"Aizawa","sequence":"additional","affiliation":[{"name":"Diabetes and Vascular Medicine, University of Exeter Medical School, National Institute for Health Research Exeter Clinical Research Facility, Exeter, U.K."}]},{"given":"Cecilia","family":"Kennb\u00e4ck","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Malm\u00f6, Lund University, Lund, Sweden"}]},{"given":"Francesco","family":"Casanova","sequence":"additional","affiliation":[{"name":"Diabetes and Vascular Medicine, University of Exeter Medical School, National Institute for Health Research Exeter Clinical Research Facility, Exeter, U.K."}]},{"given":"Margaretha","family":"Persson","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Malm\u00f6, Lund University, Lund, Sweden"}]},{"given":"Kim","family":"Gooding","sequence":"additional","affiliation":[{"name":"Diabetes and Vascular Medicine, University of Exeter Medical School, National Institute for Health Research Exeter Clinical Research Facility, Exeter, U.K."}]},{"given":"Phillip E.","family":"Gates","sequence":"additional","affiliation":[{"name":"Diabetes and Vascular Medicine, University of Exeter Medical School, National Institute for Health Research Exeter Clinical Research Facility, Exeter, U.K."}]},{"given":"Helen","family":"Looker","sequence":"additional","affiliation":[{"name":"Division of Molecular and Clinical Medicine, University of Dundee, Dundee, U.K."}]},{"given":"Fiona","family":"Dove","sequence":"additional","affiliation":[{"name":"Division of Molecular and Clinical Medicine, University of Dundee, Dundee, U.K."}]},{"given":"Jill","family":"Belch","sequence":"additional","affiliation":[{"name":"Division of Molecular and Clinical Medicine, University of Dundee, Dundee, U.K."}]},{"given":"Silvia","family":"Pinnola","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy"}]},{"given":"Elena","family":"Venturi","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy"}]},{"given":"Michaela","family":"Kozakova","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy"},{"name":"Department of Surgical, Medical, Molecular, and Critical Area Pathology, University of Pisa, Pisa, Italy"}]},{"given":"Isabel","family":"Goncalves","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Malm\u00f6, Lund University, Lund, 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