Evidence mapPaperPMID 40616198Full record

ArticleDiabetic medicine : a journal of the British Diabetic Association2025

Arterial stiffness and atherosclerosis and incident cardiovascular events and all-cause mortality in individuals with manifest cardiovascular disease with and without type 2 diabetes.

Jan F de Leijer, Frank L J Visseren, Birgitta K Velthuis, Ynte M Ruigrok, Jaco J M Zwanenburg, Manon G van der Meer, Martin Teraa, Pim A de Jong, Thomas T van Sloten, UCC‐SMART study group

Abstract read
In one paragraph

Article in Diabetic medicine : a journal of the British Diabetic Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Jan F de LeijerDepartment of Vascular Medicine & Endocrinology, University Medical Center Utrecht, Utrecht, The Netherlands.ORCID https://orcid.org/0000-0003-4254-8923
Frank L J VisserenDepartment of Vascular Medicine & Endocrinology, University Medical Center Utrecht, Utrecht, The Netherlands.ORCID https://orcid.org/0000-0003-3951-5223
Birgitta K VelthuisDepartment of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.ORCID https://orcid.org/0000-0002-2542-9474
Ynte M RuigrokDepartment of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht, The Netherlands.ORCID https://orcid.org/0000-0002-5396-2989
Jaco J M ZwanenburgTranslational Neuroimaging Group, Center for Image Sciences, University Medical Center Utrecht, Utrecht, The Netherlands.ORCID https://orcid.org/0000-0002-4282-5719
Manon G van der MeerDepartment of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.ORCID https://orcid.org/0009-0008-5839-167X
Martin TeraaDepartment of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.ORCID https://orcid.org/0000-0002-6751-6752
Pim A de JongDepartment of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.ORCID https://orcid.org/0000-0003-4840-6854
Thomas T van SlotenDepartment of Vascular Medicine & Endocrinology, University Medical Center Utrecht, Utrecht, The Netherlands.ORCID https://orcid.org/0000-0003-2870-482X
UCC‐SMART study group

Funding

Diabetes FondsEuropean Foundation for the Study of Diabetes
6 · The paper itself

Abstract

backgroundIt is unclear if arterial stiffness and atherosclerosis are differentially related to cardiovascular events and mortality in individuals with manifest cardiovascular disease with and without type 2 diabetes (T2DM) and to what extent they mediate the relation between T2DM and these outcomes.

methodsProspective data were used from the UCC-SMART cohort, including individuals with manifest cardiovascular disease (n = 9465). Arterial stiffness (brachial pulse pressure and carotid artery distensibility coefficient (DC)) and atherosclerosis (presence of carotid plaque and ankle-brachial index <0.9) were determined. Cardiovascular events included non-fatal stroke, non-fatal myocardial infarction and cardiovascular death. Cox regression and structural equation models were used with adjustment for confounders.

resultsOver a median follow-up of 10.3 years, 2087 cardiovascular events and 2808 deaths occurred. Higher brachial pulse pressure was related to cardiovascular events and mortality in individuals with T2DM and without T2DM (HRs ≥ 1.09; 95% confidence intervals (CIs) between 1.03 and 1.30). Lower carotid artery DC was related to mortality in individuals with T2DM and without T2DM (hazard ratios (HRs) ≥ 1.20; 95% CI between 1.00 and 1.48), but only related to cardiovascular events in individuals without T2DM (HR 1.34; 95% CI between 1.20 and 1.49). Carotid and lower extremity atherosclerosis were both related to cardiovascular events and mortality in individuals with T2DM and without T2DM (HRs ≥ 1.52; 95% CI between 1.27 and 2.21). Up to 8.1% and 16.3% of the relation between T2DM and outcomes was mediated through arterial stiffness and atherosclerosis, respectively.

conclusionArterial stiffness and atherosclerosis are independently, but not differentially, related to cardiovascular events and mortality in individuals with manifest cardiovascular disease with and without T2DM. Atherosclerosis explained a larger proportion of the relation between T2DM and outcomes.

Indexed as

AtherosclerosisCardiovascular DiseasesDiabetes Mellitus, Type 2Diabetic AngiopathiesVascular StiffnessAgedAnkle Brachial IndexFemaleHumansIncidenceMaleMiddle AgedProspective StudiesRisk Factorsarterial stiffnessatherosclerosiscardiovascular diseasemediation analysistype 2 diabetes

Identifiers

PMID40616198
PMCPMC12352715

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.