Management of dyslipidaemia in patients with comorbidities—facing the challenge: type 1 diabetes mellitus

Susanne Kaser; Dobromir Dobrev; Bianca Rocca; Juan Carlos Kaski; Stefan Agewall; Heinz Drexel

doi:10.1093/ehjcvp/pvaf023

. 2025 May 21;11(4):380–386. doi: 10.1093/ehjcvp/pvaf023

Management of dyslipidaemia in patients with comorbidities—facing the challenge: type 1 diabetes mellitus

Susanne Kaser ¹, Dobromir Dobrev ^2,^3,^4,^✉,^c, Bianca Rocca ^5,^✉, Juan Carlos Kaski ^6,^✉, Stefan Agewall ^7,^✉, Heinz Drexel ^8,^9,^10,^11,^✉

PMCID: PMC12231131 PMID: 40396997

Abstract

Type 1 diabetes is associated with excess cardiovascular risk. In contrast to type 2 diabetes, however, age at the onset of type 1 diabetes and sex are major predictors of cardiovascular risk, while the role of low-density lipoprotein cholesterol (LDL-C) and lipid-lowering therapy is less clear.

Since most data on the effects of lipid-lowering treatments are obtained from randomized clinical trials that included very predominantly patients with type 2 diabetes, it is almost impossible to specifically discern endpoints in type 1 diabetes. Inversely, most data specific for type 1 diabetes are obtained from real world findings. Consequently, the evidence on efficacy and safety of lipid-lowering therapies available from randomized clinical trials arises very predominantly from type 2 diabetes. Thus, this specific review summarizes the evidence of lipid-lowering drug classes in reducing cardiovascular risk in patients with type 1 diabetes.

Keywords: Type 1 diabetes mellitus, Lipid lowering drugs, Dyslipidaemia, Cardiovascular risk, Comorbidities, Randomized clinical trials

Preface

Type 1 and type 2 diabetes mellitus (T1DM and T2DM) have distinct underlying pathobiology and may exert quite different effects on lipid metabolism. In T1DM, characterized by the absence of endogenous insulin, subcutaneous insulin substitution therapy provides insulin to the body via the peripheral circulation. In contrast, physiologically and in T2DM, endogenous insulin from the pancreatic beta cell via the portal route first arrives at the liver and only then reaches the peripheral circulation.

Insulin is an activator of lipoprotein lipase, the key enzyme for triglyceride hydrolysis. Thus, management of triglycerides and other aspects of lipid metabolism are fundamentally different between T1DM and T2DM. Therefore, this article specifically addresses lipid-lowering therapy in T1DM, and a subsequent review article will focus on T2DM.

Effects of lipid-lowering agents on cardiovascular risk in type 1 diabetes

Background

Epidemiology of cardiovascular disease in type 1 diabetes

Type 1 diabetes is associated with highly increased cardiovascular risk and mortality.^1–3

In a previous study, cardiovascular disease was the most common underlying cause of death in patients with type 1 diabetes.⁴ Excess total and cardiovascular mortality strongly depend on sex and the onset of disease being highest in patients diagnosed with type 1 diabetes before the age of 10 years resulting in a 17.7 life years loss in women and a 14.2 life years loss in men.¹ In a Swedish cohort, adjusted hazard ratio (HR) for cardiovascular mortality was 7.38 [95% Confidence Interval (CI) 3.65–14.94] in patients diagnosed before the age of 10 years and 3.64 (95% CI 2.34–5.66) for patients diagnosed at an age between 26 and 30 years.¹ In general, excess cardiovascular risk is significantly higher in female than in male patients with type 1 diabetes when compared with nondiabetic women and men,⁵ showing the highest excess cardiovascular mortality with a HR of 9.35 (95% CI 2.68–32.62) in women and a HR of 6.9 (95% CI 3.11–15.33) in men with type 1 diabetes diagnosed before age of 10 years when compared to healthy controls.¹

Pathophysiology of cardiovascular disease in type 1 diabetes

LDL cholesterol

Underlying mechanisms of cardiovascular disease in type 1 diabetes are multifactorial, including both classical and nonclassical risk factors. Remarkably, the contribution of classical risk factors, especially LDL-cholesterol on atherogenesis is less clear in patients with type 1 diabetes when compared to type 2 diabetes. Pathophysiological aspects have recently been reviewed in detail elsewhere.⁶

LDL-cholesterol was identified as an independent risk factor for cardiovascular disease in several studies.^7–9

In an observational study, 1 mmol/L increase in LDL-C was associated with a 9% increase in cardiovascular disease in type 1 diabetics without lipid-lowering therapy and a 2% increase in those with lipid-lowering medication, suggesting a prominence of nonclassical risk factors in atherogenesis in type 1 diabetes.¹⁰ In a retrospective longitudinal study analysing 6192 adult patients with type 1 diabetes, the risk of nonfatal cardiovascular events was lower in patients with higher adherence. Paradoxically, there was a negative, nonsignificant trend towards an indirect association between discontinuation of lipid-lowering therapies and fatal cardiovascular events in this study probably explained by a relatively low number of fatal cardiovascular events.¹¹ While the predictive value of LDL-C concentration on cardiovascular risk in type 1 diabetes is partly controversial, high atherogenicity of LDL particles in type 1 diabetes is beyond dispute; LDL particles are typically smaller in type 1 diabetes¹² resulting in increased oxidation, enhanced uptake into macrophages and formation of foam cells.¹³ Paradoxically, HDL-cholesterol is usually normal or increased in well-controlled patients with type 1 diabetes. However, the structure of HDL particles is altered in type 1 diabetes, leading to dysfunctional particles with reduced atheroprotective properties.¹³

Hypertension

Increased blood pressure, especially increased systolic blood pressure, was found to be independently associated with cardiovascular disease and major cardiovascular in the The Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interactions and Complications (EDIC) trial.¹⁴

Hyperglycaemia and glycaemic fluctuation

HbA1c is strongly related to cardiovascular disease in type 1 diabetes (DCCT/EDIC, Diabetes, 2016).¹⁴ Accordingly, intensive treatment was associated with a marked decrease of major cardiovascular events in the DCCT/EDIC study.¹⁵ Mechanistically, hyperglycaemia and glycaemic variability trigger expression of pro-inflammatory cytokines, procoagulant factors, growth factors, matrix proteins and vasoconstrictors, activation of the polyol pathway and formation of advanced glycation end products.⁶

Nonclassical risk factors and comorbidities

Underlining the relevance of nontraditional risk factors in cardiovascular disease (CVD) in type 1 diabetes, acute myocardial infarction was increased by 80% in type 1 diabetic individuals with five modifiable risk factors including HbA1c, blood pressure, LDL-C at target (LDL-C <3 mmol/L), albuminuria and smoking, when compared to nondiabetic matched controls.¹⁶ When none of these risk factors were at target, risk for acute myocardial infarction was increased more than 12 folds.¹⁶ Supporting this finding, a recent Korean study revealed more than six- and four-fold increased risks for myocardial infarction and stroke [myocardial infarction: HR 6.7 (95% CI 2.44–18.72), stroke: HR 4.65 (95% CI 1.70–12.71)] even after adjusting for sex, age, family income, hypertension, and dyslipidaemia.¹⁷

Subclinical inflammation has also been widely discussed to contribute to atherogenesis in type 1 diabetes. In a prospective randomized trial in patients with acute myocardial infarction, low-dose colchicine for 30 days was associated with a lower risk of ischaemic cardiovascular events. In this trial, 20.2% of patients suffered from diabetes, however no details on the diabetes type of included patients were shown.¹⁸ Beneficial effects on cardiovascular morbidity and mortality of low dose colchicine therapy were also found in patients with chronic coronary disease, including 18.2% of patients with diabetes.¹⁹

These data suggest a more prominent role of anti-inflammatory therapies in cardiovascular disease in the future. Besides colchicine, these treatment options also include bempedoic acid, which has also shown to reduce inflammatory markers in treated patients.^20–23 Further data including randomized trials are warranted to test the effect of anti-inflammatory therapies on cardiovascular risk in type 1 diabetes.

Based on a recent population-based study reporting increased cardiovascular risk of patients with autoimmune disease,²⁴ impaired immune function might also contribute to enhanced atherogenesis in type 1 diabetes.⁶

Importantly, frequent comorbidities such as diabetic nephropathy which importantly is strongly genetically determined²⁵ and autonomic cardiac neuropathy are also independently associated with cardiovascular risk.^26,27

Further supporting a major role of nontraditional risk factors in cardiovascular disease in type 1 diabetes, neither Framingham nor UKPDS CHD models turned out to adequately predict cardiovascular disease in patients with type 1 diabetes.²⁸ In contrast, arterial stiffness, which is highly prevalent in patients with longstanding type 1 diabetes, was found to be associated with the STENO risk score for cardiovascular events.²⁹ Inhibitors of the renin-angiotensin system, calcium channel antagonists and lipid-lowering agents including statins, ezetimibe, and PCSK9 inhibitors might exert beneficial effects on arterial stiffness.^30,31

Besides inflammation and arterial stiffness, procoagulation is also discussed to contribute to increased cardiovascular risk in patients with type 1 diabetes. Increased platelet activation was found in young adult subjects with type 1 diabetes without overt cardiovascular disease and stable glycaemic control.³² Even stressing the close interaction between nonclassical and classical risk factors in patients with type 1 diabetes increased platelet activation and was found to be related to glycaemic control.³³

Current guidelines for lipid-lowering treatment in type 1 diabetes

Information on lipid-lowering effects on cardiovascular events in type 1 diabetes is very limited as only a very small number of patients with type 1 diabetes were included in cardiovascular outcome trials. Actually, recommendations for lipid-lowering therapy are often based on real-world data from different sources, including large national registries. In a prospective observational study, data were analysed from the Swedish National Diabetes Register showing that lipid-lowering therapy is associated with a strong decrease in cardiovascular risk in patients with type 1 diabetes.³⁴

In contrast to type 2 diabetes and reflecting limited data availability from randomized trials, international recommendations for lipid-lowering therapies in type 1 diabetes are rather vague.

Table 1 shows the current ESC guidelines on lipid-lowering therapies in type 1 diabetes.³⁵ While statins should be considered in all patients with type 1 diabetes older than 40 years, statin treatment is only recommended in younger patients with high cardiovascular risk or microvascular end-organ damage.

Table 1.

Current ESC guidelines on lipid lowering therapies in type 1 diabetes

	Class^a	Evidence level
Statins should be considered for LDL-C lowering in adults older than 40 years with T1DM without a history of CVD to reduce CV risk.	IIa	B
Statins should be considered for use in adults younger than 40 years with T1DM and other risk factors of CVD or microvascular end-organ damage or 10-year CVD risk ≥10% to reduce CVD risk.	IIa	B
The use of the Scottish/Swedish risk prediction model may be considered to estimate 10-year CVD risk in patients with T1DM.	IIb	B

Open in a new tab

Adapted from Table 3, 2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes, European Heart Journal (2023) 44, 4043–4140.³⁵

Class of recommendation.

Lipid-lowering agents

Statins

A meta-analysis of 14 trials including 18 686 patients with diabetes in total and 1466 patients with type 1 diabetes found a 21% decrease per mmol/L LDL-C reduction irrespective of underlying diabetes diagnosis. Although a subgroup analysis revealed similar risk reduction for patients with type 1 and type 2 diabetes (relative risk: 0.79, 95% CI 0.72–0.86), no significant risk reduction was found when patients with type 1 diabetes were analysed separately (relative risk: 0.79, 95% CI 0.62–1.01).³⁶ In this meta-analysis, 56% of patients with type 1 diabetes, 36% of patients with type 2 diabetes, and 60% of nondiabetic controls suffered from cardiovascular disease. Mean LDL-C was 3.4 mmol/l in type 1 and type 2 diabetics and 3.9 mmol/l in nondiabetic controls at baseline.

In a Korean study analysing national health insurance data, statin treatment was associated with lower cardiovascular events in patients with type 1 diabetes (HR 0.76, 95% CI 0.66–0.88).³⁷

Initiation of and adherence to statin treatment is often challenging due to concerns of muscular side effects and worsening of hyperglycaemia or new-onset diabetes. However, and in contrast to real-world data, statin treatment was associated only with a small excess of mild myalgia in randomized trials.³⁸ A meta-analysis shows that statin treatment is associated with a very slight mean increase of HbA1c levels of 0.06–0.08%.³⁹ In a previous prospective, observational study, the risk for deterioration of insulin sensitivity attributable to statin treatment was 36.7% in patients with type 1 diabetes.⁴⁰

To conclude from these studies, cardiovascular risk reduction clearly overweighs the risk of worsening glycaemic control in patients with type 1 diabetes at increased cardiovascular risk. Nevertheless, low adherence to statin therapy in patients with type 1 diabetes was shown in a Swedish registry study which reported that 42% of patients had discontinued their treatment after 36 months.¹¹ In contrast, 79% of participants of the Adolescent Type 1 Diabetes Cardio-renal Intervention Trial AdDIT Study Group were still on statin therapy at the end of the study.⁴¹

Ezetimibe

Cardiovascular benefits were shown for the cholesterol absorption inhibitor ezetimibe in the IMPROVE-IT trial.⁴² In this study, patients after a recent acute coronary syndrome were allocated to simvastatin + ezetimibe or simvastatin alone. After 7 years, a difference in LDL-C of 0.4 mmol/L (1.4 vs. 1.8 mmol/L) resulted in an absolute risk reduction of 2% of the composite endpoint of cardiovascular death, nonfatal myocardial infarction, unstable angina requiring rehospitalization, coronary revascularization, or nonfatal stroke. A pre-specified subgroup analysis revealed that among patients younger than 75 years, reduction of the primary end point differed significantly between those with and without diabetes, showing a significant risk reduction only in diabetic patients. Cardiovascular risk reduction was comparable in patients with or without diabetes older than 75 years. While no information on diabetes type was given in this study, antidiabetic medication suggests predominant inclusion of patients with type 2 diabetes.⁴³ The benefit of adding ezetimibe to statin was also enhanced in high-risk patients without diabetes.⁴³ In another study combination therapy of ezetimibe and low-dose atorvastatin was found to be associated with decreased cardiovascular mortality, nonfatal myocardial infarction, coronary artery revascularization, hospitalization for heart failure or nonfatal stroke in patients after drug eluting stent implantation. A total of 49.2% of included patients suffered from diabetes in this study, however, no data on the diabetes type of participants are available from this study.⁴⁴ In an open label noninferiority trial, patients with cardiovascular disease received either moderate-intensity statin with ezetimibe or high-intensity statin monotherapy. In this study, including only a few patients with diabetes, the combination therapy was noninferior to the high-intensity statin treatment.⁴⁵

PCSK9 inhibitors

In the Odyssey Outcome trial, the efficacy and safety of alirocumab treatment was tested in patients with established coronary artery disease, including 28.8% of patients with diabetes.^46,47

The composite endpoint encompassing death from coronary heart disease, nonfatal myocardial infarction, fatal or nonfatal ischaemic stroke, or unstable angina requiring hospitalization was 12.5% in the alirocumab group and 14.5% in the control group. LDL-C levels were 1.7 mmol/L in the alirocumab group and 2.7 mmol/L in the control group.

While no further information on the diabetes type of participants was given in the Odyssey Outcome trial, baseline characteristics of another pooled analysis of all phase 3 Odyssey trials showed a total number of only 15 patients with type 1 diabetes.⁴⁸

In the Fourier trial⁴⁹ investigating the effect of evolocumab therapy in patients with established cardiovascular disease on statin treatment pre-specified subgroup analysis showed comparable reductions in the composite primary endpoint of cardiovascular death, myocardial infarction, stroke, hospitalization for unstable angina, or coronary revascularization in patients with and without diabetes [HR 0.83 (95% CI 0.75–0.93) vs. 0.87 (95% CI 0.79–0.96), P = 0.60).⁵⁰ Baseline LDL-C levels (2.3 mmol/L vs. 2.4 mmol/L) and LDL-reductions were comparable in patients with and without diabetes and LDL-C reductions were 57% in patients with diabetes (95% CI 56–58) and 60% in patients without diabetes (95% CI 60–61). Two hundred eighty-six of 10 081 diabetic patients (3%) were classified as type 1 diabetics.⁵⁰

In a meta-analysis, treatment with alirocumab or evolocumab was associated with a mean decrease in LDL-C levels by 58%, a mean reduction of Lp(a) levels of 30%, and a decrease in MACE by 18% after 51 years in patients with diabetes, including 76 patients with type 1 diabetes from of the ODYSSEY DM-Insulin trial also.^51,52

No studies on the effects of inclisiran treatment on cardiovascular events are available yet.

Access to PCSK9 inhibitor treatment might be limited in some countries and the cost-effectiveness of PCSK9 inhibitor therapy remains controversial.⁵³

ATP citrate lyase inhibitor

Efficacy of bempedoic acid treatment in cardiovascular risk reduction in patients with high cardiovascular risk and statin intolerance or poor statin tolerance was shown in the CLEAR outcome trial.⁵⁴ While 6373 of 13 970 patients suffered from diabetes in this trial, the definition of diabetes as indicated in the baseline characteristics table suggests predominant or exclusive enrolment of patients with type 2 diabetes.

Other lipid-lowering agents.

To the best of our knowledge, there are no specific trials available investigating the effects of fibrates on cardiovascular outcome in patients with type 1 diabetes. In contrast, in patients with type 2 diabetes, recent real-world data suggested a cardiovascular benefit of fenofibrate therapy.^55,56

Noteworthy, fibrate therapy is currently under investigation for the treatment or prevention of diabetic retinopathy in the LENS trial.⁵⁷ Only very recently, fibrate treatment did not preserve residual beta cell function in patients with newly diagnosed type 1 diabetes.⁵⁸

Data on omega 3 fatty acids on cardiovascular effects in type 1 diabetes are very limited. In a small-sized and short-term prospective study, no benefit of n3-PUFA on vascular health in type 1 diabetes was found.⁵⁹

Summary and conclusion

In summary, while real-world data suggest protective effects of lipid-lowering therapy in type 1 diabetes, only little evidence from randomized trials is available. In randomized clinical trials, most data on the efficacy and safety of lipid-lowering drugs in patients with type 1 diabetes are available from subgroup analyses only with the most robust data for statins. Importantly, data from subgroup analyses are most often hypothesis-generating but less credible than data obtained from the whole study population, while selection bias might limit the interpretation of real-world data.⁶⁰

Thus, prospective cardiovascular outcome trials in patients with type 1 diabetes are warranted to determine optimal LDL-C goals, the best choice of lipid-lowering agent and identify patients with the highest benefit of treatment. These include huge prospective, randomized studies of lipid-lowering therapy on cardiovascular disease in both, a primary prevention and secondary prevention setting as well.

Importantly, early onset of diabetes and female sex are associated with very high excess cardiovascular risk and should be included in cardiovascular risk prediction in patients with type 1 diabetes.

Novel prediction models for cardiovascular risk including age at onset of type 1 diabetes and sex are urgently needed to optimize cardiovascular risk reduction in patients with type 1 diabetes.

Noteworthy, no safety concerns were found for very low LDL-C levels in a meta-analysis including patients with diabetes also.⁶¹

Acknowledgements

We thank Dr Cornelia Malin for excellent assistance in preparing the revised manuscript.

Contributor Information

Susanne Kaser, Department of Internal Medicine I, Medical University of Innsbruck, 6020 Innsbruck, Austria.

Dobromir Dobrev, Institute of Pharmacology, West German Heart and Vascular Center, University Duisburg-Essen, 45122 Essen, Germany; Department of Medicine and Research Center, Montreal Heart Institute and Université de Montréal, H1T 1C8 Montréal, Canada; Department of Integrative Physiology, Baylor College of Medicine, 77030 Houston, TX, USA.

Bianca Rocca, Department of Medicine, LUM University, 70010 Casamassima (BA), Italy.

Juan Carlos Kaski, Division of Cardiovascular Medicine, Molecular and Clinical Sciences Research Institute, St George's University of London, SW17 0RE London, UK.

Stefan Agewall, Institute of Clinical Sciences, Karolinska Institute of Danderyd, 171 77 Stockholm, Sweden.

Heinz Drexel, Vorarlberg Institute for Vascular Investigation & Treatment (VIVIT) at the Academic Teaching Hospital Feldkirch, Carinagasse 47, 6800 Feldkirch, Austria; Private University in the Principality of Liechtenstein, Medical Sciences, Dorfstrasse 24, 9495 Triesen, Liechtenstein; Vorarlberger Landeskrankenhausbetriebsgesellschaft, 6800 Feldkirch, Austria; Drexel University College of Medicine, 2900 Queen Ln, Philadelphia PA 19129, USA.

Data availability

No new data were generated or analysed in support of this research.

References

1. Rawshani A, Sattar N, Franzen S, Rawshani A, Hattersley AT, Svensson AM, Eliasson B, Gudbjörnsdottir S. Excess mortality and cardiovascular disease in young adults with type 1 diabetes in relation to age at onset: a nationwide, register-based cohort study. Lancet 2018;392:477–486. [DOI] [PMC free article] [PubMed] [Google Scholar]
2. Rawshani A, Rawshani A, Gudbjornsdottir S. Mortality and cardiovascular disease in type 1 and type 2 diabetes. N Engl J Med 2017;377:300–301. [DOI] [PubMed] [Google Scholar]
3. Manrique-Acevedo C, Hirsch IB, Eckel RH. Prevention of cardiovascular disease in type 1 diabetes. Reply. N Engl J Med 2024;390:2227. [DOI] [PubMed] [Google Scholar]
4. Morrish NJ, Wang SL, Stevens LK, Fuller JH, Keen H. Mortality and causes of death in the WHO Multinational Study of Vascular Disease in Diabetes. Diabetologia 2001;44:S14–S21. [DOI] [PubMed] [Google Scholar]
5. Huxley RR, Peters SA, Mishra GD, Woodward M. Risk of all-cause mortality and vascular events in women versus men with type 1 diabetes: a systematic review and meta-analysis. Lancet Diabetes Endocrinol 2015;3:198–206. [DOI] [PubMed] [Google Scholar]
6. Vergès B. Cardiovascular disease in type 1 diabetes, an underestimated danger: epidemiological and pathophysiological data. Atherosclerosis 2024;394:117158. [DOI] [PubMed] [Google Scholar]
7. Bebu I, Braffett BH, Pop-Busui R, Orchard TJ, Nathan DM, Lachin JM, DCCT/EDIC Research Group . The relationship of blood glucose with cardiovascular disease is mediated over time by traditional risk factors in type 1 diabetes: the DCCT/EDIC study. Diabetologia 2017;60:2084–2091. [DOI] [PMC free article] [PubMed] [Google Scholar]
8. Miller RG, Orchard TJ, Costacou T. Risk factors differ by first manifestation of cardiovascular disease in type 1 diabetes. Diabetes Res Clin Pract 2020;163:108141. [DOI] [PMC free article] [PubMed] [Google Scholar]
9. Orchard TJ, Forrest KY, Kuller LH, Becker DJ, Pittsburgh Epidemiology of Diabetes Complications, S . Lipid and blood pressure treatment goals for type 1 diabetes: 10-year incidence data from the Pittsburgh Epidemiology of Diabetes Complications Study. Diabetes Care 2001;24:1053–1059. [DOI] [PubMed] [Google Scholar]
10. Hero C, Svensson A, Gidlund P, Gudbjörnsdottir S, Eliasson B, Eeg-Olofsson K. LDL cholesterol is not a good marker of cardiovascular risk in type 1 diabetes. Diabet Med 2016;33:316–323. [DOI] [PubMed] [Google Scholar]
11. Hero C, Karlsson SA, Franzén S, Svensson A, Miftaraj M, Gudbjörnsdottir S, Andersson Sundell K, Eliasson B, Eeg-Olofsson K. Adherence to lipid-lowering therapy and risk for cardiovascular disease and death in type 1 diabetes mellitus: a population-based study from the Swedish National Diabetes Register. BMJ Open Diabetes Res Care 2020;8:e000719. [DOI] [PMC free article] [PubMed] [Google Scholar]
12. Hughes TA, Calderon RM, Diaz S, Mendez AJ, Goldberg RB. Lipoprotein composition in patients with type 1 diabetes mellitus: impact of lipases and adipokines. J Diabetes Complications 2016;30:657–668. [DOI] [PubMed] [Google Scholar]
13. Vergès B. Dyslipidemia in type 1 diabetes: a masked danger. Trends Endocrinol Metab 2020;31:422–434. [DOI] [PubMed] [Google Scholar]
14. Writing Group for the, D. E. R. G . Coprogression of cardiovascular risk factors in type 1 diabetes during 30 years of follow-up in the DCCT/EDIC study. Diabetes Care 2016;39:1621–1630. [DOI] [PMC free article] [PubMed] [Google Scholar]
15. Nathan DM, Cleary PA, Backlund JY, Genuth SM, Lachin JM, Orchard TJ, Raskin P, Zinman B, Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study Research Group . Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N Engl J Med 2005;353:2643–2653. [DOI] [PMC free article] [PubMed] [Google Scholar]
16. Rawshani A, Rawshani A, Franzén S, Eliasson B, Svensson A, Miftaraj M, McGuire DK, Sattar N, Rosengren A, Gudbjörnsdottir S. Range of risk factor levels: control, mortality, and cardiovascular outcomes in type 1 diabetes mellitus. Circulation 2017;135:1522–1531. [DOI] [PMC free article] [PubMed] [Google Scholar]
17. Kim SE, Han K, Cho WK, Suh BK. Cardiovascular complications, kidney failure, and mortality in young-onset type 1 and type 2 diabetes: data from the Korean National Health Insurance Service. Diabetes Care 2025;48:422–429. [DOI] [PubMed] [Google Scholar]
18. Tardif J, Kouz S, Waters DD, Bertrand OF, Diaz R, Maggioni AP, Pinto FJ, Ibrahim R, Gamra H, Kiwan GS, Berry C, López-Sendón J, Ostadal P, Koenig W, Angoulvant D, Grégoire JC, Lavoie M, Dubé M, Rhainds D, Provencher M, Blondeau L, Orfanos A, L'Allier PL, Guertin M, Roubille F. Efficacy and safety of low-dose colchicine after myocardial infarction. N Engl J Med 2019;381:2497–2505. [DOI] [PubMed] [Google Scholar]
19. Nidorf SM, Fiolet AT, Mosterd A, Eikelboom JW, Schut A, Opstal TS, The SH, Xu X, Ireland MA, Lenderink T, Latchem D, Hoogslag P, Jerzewski A, Nierop P, Whelan A, Hendriks R, Swart H, Schaap J, Kuijper AF, van Hessen MW, Saklani P, Tan I, Thompson AG, Morton A, Judkins C, Bax WA, Dirksen M, Alings M, Hankey GJ, Budgeon CA, Tijssen JG, Cornel JH, Thompson PL, LoDoCo2 Trial Investigators . Colchicine in patients with chronic coronary disease. N Engl J Med 2020;383:1838–1847. [DOI] [PubMed] [Google Scholar]
20. Johansen NJ, Knop FK. The potential of colchicine for lowering the risk of cardiovascular events in type 1 diabetes. Eur Heart J Cardiovasc Pharmacother 2023;9:311–317. [DOI] [PubMed] [Google Scholar]
21. Agewall S. Focus on prevention in diabetes mellitus and lipid disorder. Eur Heart J Cardiovasc Pharmacother 2023;9:295–296 [DOI] [PubMed] [Google Scholar]
22. Lawler PR, Bhatt DL, Godoy LC, Lüscher TF, Bonow RO, Verma S, Ridker PM. Targeting cardiovascular inflammation: next steps in clinical translation. Eur Heart J 2021;42:113–131. [DOI] [PubMed] [Google Scholar]
23. Stroes ES, Bays HE, Banach M, Catapano AL, Duell PB, Laufs U, Mancini GJ, Ray KK, Sasiela WJ, Zhang Y, Gotto AM. Bempedoic acid lowers high-sensitivity C-reactive protein and low-density lipoprotein cholesterol: analysis of pooled data from four phase 3 clinical trials. Atherosclerosis 2023;373:1–9. [DOI] [PubMed] [Google Scholar]
24. Conrad N, Verbeke G, Molenberghs G, Goetschalckx L, Callender T, Cambridge G, Mason JC, Rahimi K, McMurray JJV, Verbakel JY. Autoimmune diseases and cardiovascular risk: a population-based study on 19 autoimmune diseases and 12 cardiovascular diseases in 22 million individuals in the UK. Lancet 2022;400:733–743. [DOI] [PubMed] [Google Scholar]
25. Mohammedi K, Marre M, Alhenc-Gelas F. Genetic predisposition to nephropathy and associated cardiovascular disease in people with type 1 diabetes: role of the angiotensinI-converting enzyme (ACE), and beyond; a narrative review. Cardiovasc Diabetol 2024;23:453. [DOI] [PMC free article] [PubMed] [Google Scholar]
26. Vistisen D, Andersen GS, Hansen CS, Hulman A, Henriksen JE, Bech-Nielsen H, Jørgensen ME. Prediction of first cardiovascular disease event in type 1 diabetes mellitus: the steno type 1 risk engine. Circulation 2016;133:1058–1066. [DOI] [PubMed] [Google Scholar]
27. Miller RG, Costacou T, Orchard TJ. Risk factor modeling for cardiovascular disease in type 1 diabetes in the Pittsburgh Epidemiology of Diabetes Complications (EDC) study: a comparison with the diabetes control and complications trial/Epidemiology of Diabetes interventions and complications study (DCCT/EDIC). Diabetes 2019;68:409–419. [DOI] [PMC free article] [PubMed] [Google Scholar]
28. Zgibor JC, Piatt GA, Ruppert K, Orchard TJ, Roberts MS. Deficiencies of cardiovascular risk prediction models for type 1 diabetes. Diabetes Care 2006;29:1860–1865. [DOI] [PubMed] [Google Scholar]
29. Helleputte S, Van Bortel L, Verbeke F, Op ‘t Roodt J, Calders P, Lapauw B, De Backer T. Arterial stiffness in patients with type 1 diabetes and its comparison to cardiovascular risk evaluation tools. Cardiovasc Diabetol 2022;21:97. [DOI] [PMC free article] [PubMed] [Google Scholar]
30. Battistoni A, Michielon A, Marino G, Savoia C. Vascular aging and Central aortic blood pressure: from pathophysiology to treatment. High Blood Press Cardiovasc Prev 2020;27:299–308. [DOI] [PubMed] [Google Scholar]
31. González-Clemente J, Cano A, Albert L, Giménez-Palop O, Romero A, Berlanga E, Vendrell J, Llauradó G. Arterial stiffness in type 1 diabetes: the case for the arterial wall itself as a target organ. J Clin Med 2021;10:3616. [DOI] [PMC free article] [PubMed] [Google Scholar]
32. Zaccardi F, Rizzi A, Petrucci G, Ciaffardini F, Tanese L, Pagliaccia F, Cavalca V, Ciminello A, Habib A, Squellerio I, Rizzo P, Tremoli E, Rocca B, Pitocco D, Patrono C. In vivo platelet activation and aspirin responsiveness in type 1 diabetes. Diabetes 2016;65:503–509. [DOI] [PubMed] [Google Scholar]
33. Zaccardi F, Rocca B, Rizzi A, Ciminello A, Teofili L, Ghirlanda G, De Stefano V, Pitocco D. Platelet indices and glucose control in type 1 and type 2 diabetes mellitus: a case-control study. Nutr Metab Cardiovasc Dis 2017;27:902–909. [DOI] [PubMed] [Google Scholar]
34. Hero C, Rawshani A, Svensson A, Franzén S, Eliasson B, Eeg-Olofsson K, Gudbjörnsdottir S. Association between use of lipid-lowering therapy and cardiovascular diseases and death in individuals with type 1 diabetes. Diabetes Care 2016;39:996–1003. [DOI] [PubMed] [Google Scholar]
35. Marx N, Federici M, Schütt K, Müller-Wieland D, Ajjan RA, Antunes MJ, Christodorescu RM, Crawford C, Di Angelantonio E, Eliasson B, Espinola-Klein C, Fauchier L, Halle M, Herrington WG, Kautzky-Willer A, Lambrinou E, Lesiak M, Lettino M, McGuire DK, Mullens W, Rocca B, Sattar N, Prescott E, Cosentino F, Abdelhamid M, Aboyans V, Antoniou S, Asteggiano R, Baumgartner I, Buccheri S, Bueno H, Čelutkienė J, Chieffo A, Christersson C, Coats A, Cosyns B, Czerny M, Deaton C, Falk V, Ference BA, Filippatos G, Fisher M, Huikuri H, Ibanez B, Jaarsma T, James S, Khunti K, Køber L, Koskinas KC, Lewis BS, Løchen M, McEvoy JW, Mihaylova B, Mindham R, Neubeck L, Nielsen JC, Parati G, Pasquet AA, Patrono C, Petersen SE, Piepoli MF, Rakisheva A, Rossello X, Rossing P, Rydén L, Standl E, Tokgozoglu L, Touyz RM, Visseren F, Volpe M, Vrints C, Witkowski A, Hazarapetyan L, Zirlik A, Rustamova Y, van de Borne P, Sokolović Š, Gotcheva N, Milicic D, Agathangelou P, Vrablík M, Schou M, Hasan-Ali H, Viigimaa M, Lautamäki R, Aboyans V, Klimiashvili Z, Kelm M, Siasos G, Kiss RG, Libungan B, Durkan M, Zafrir B, Colivicchi F, Tundybayeva M, Bytyçi I, Mirrakhimov E, Trusinskis K, Saadé G, Badarienė J, Banu C, Magri CJ, Boskovic A, Hattaoui ME, Martens F, Bosevski M, Knudsen EC, Burchardt P, Fontes-Carvalho R, Vinereanu D, Mancini T, Beleslin B, Martinka E, Fras Z, Conde AC, Mellbin L, Carballo D, Bsata W, Mghaieth F, Gungor B, Mitchenko O, Wheatcroft S, Trigulova R, Prescott E, James S, Arbelo E, Baigent C, Borger MA, Buccheri S, Ibanez B, Køber L, Koskinas KC, McEvoy JW, Mihaylova B, Mindham R, Neubeck L, Nielsen JC, Pasquet AA, Rakisheva A, Rocca B, Rosselló X, Vaartjes I, Vrints C, Witkowski A, Zeppenfeld K. 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes. Eur Heart J 2023;44:4043–4140. [DOI] [PubMed] [Google Scholar]
36. Cholesterol Treatment Trialists' (CTT) Collaborators, Kearney PM, Blackwell L, Collins R, Keech A, Simes J, Peto R, Armitage J, Baigent C Efficacy of cholesterol-lowering therapy in 18,686 people with diabetes in 14 randomised trials of statins: a meta-analysis. Lancet 2008;371:117–125. [DOI] [PubMed] [Google Scholar]
37. Yoo J, Jeon J, Baek M, Song SO, Kim J. Impact of statin treatment on cardiovascular risk in patients with type 1 diabetes: a population-based cohort study. J Transl Med 2023;21:806. [DOI] [PMC free article] [PubMed] [Google Scholar]
38. Cholesterol Treatment Trialists, C . Effect of statin therapy on muscle symptoms: an individual participant data meta-analysis of large-scale, randomised, double-blind trials. Lancet 2022;400:832–845. [DOI] [PMC free article] [PubMed] [Google Scholar]
39. Cholesterol Treatment Trialists' Collaboration. Electronic address, c. n. o. a. u., and Cholesterol Treatment Trialists, C . Effects of statin therapy on diagnoses of new-onset diabetes and worsening glycaemia in large-scale randomised blinded statin trials: an individual participant data meta-analysis. Lancet Diabetes Endocrinol 2024;12:306–319. [DOI] [PMC free article] [PubMed] [Google Scholar]
40. Duvnjak L, Blaslov K. Statin treatment is associated with insulin sensitivity decrease in type 1 diabetes mellitus: a prospective, observational 56-month follow-up study. J Clin Lipidol 2016;10:1004–1010. [DOI] [PubMed] [Google Scholar]
41. Niechciał E, Acerini CL, Chiesa ST, Stevens T, Dalton RN, Daneman D, Deanfield JE, Jones TW, Mahmud FH, Marshall SM, Neil HAW, Dunger DB, Marcovecchio ML, Acerini CL, Ackland F, Anand B, Barrett T, Birrell V, Campbell F, Charakida M, Cheetham T, Chiesa ST, Deanfield JE, Cooper C, Doughty I, Dutta A, Edge J, Gray A, Hamilton-Shield J, Mann N, Marcovecchio ML, Marshall SM, Neil HAW, Rayman G, Robinson JM, Russell-Taylor M, Sankar V, Smith A, Thalange N, Yaliwal C, Benitez-Aguirre P, Cameron F, Cotterill A, Couper J, Craig M, Davis E, Donaghue K, Jones TW, King B, Verge C, Bergman P, Rodda C, Clarson C, Curtis J, Daneman D, Mahmud FH, Sochett E. Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial (AdDIT) Study Group; Adolescent Type 1 Diabetes Cardio-renal Intervention Trial AdDIT Study Group . Medication adherence during adjunct therapy with statins and ACE inhibitors in adolescents with type 1 diabetes. Diabetes Care 2020;43:1070–1076. [DOI] [PMC free article] [PubMed] [Google Scholar]
42. Cannon CP, Blazing MA, Giugliano RP, McCagg A, White JA, Theroux P, Darius H, Lewis BS, Ophuis TO, Jukema JW, De Ferrari GM, Ruzyllo W, De Lucca P, Im K, Bohula EA, Reist C, Wiviott SD, Tershakovec AM, Musliner TA, Braunwald E, Califf RM. Ezetimibe added to statin therapy after acute coronary syndromes. N Engl J Med 2015;372:2387–2397. [DOI] [PubMed] [Google Scholar]
43. Giugliano RP, Cannon CP, Blazing MA, Nicolau JC, Corbalán R, Špinar J, Park J, White JA, Bohula EA, Braunwald E. Benefit of adding ezetimibe to statin therapy on cardiovascular outcomes and safety in patients with versus without diabetes mellitus: results from IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial). Circulation 2018;137:1571–1582. [DOI] [PubMed] [Google Scholar]
44. Lee SJ, Joo JH, Park S, Kim C, Choi DW, Lee YJ, Hong SJ, Ahn CM, Kim JS, Kim BK, Ko YG, Choi D, Jang Y, Nam CM, Hong MK. Combination therapy with moderate-intensity atorvastatin and ezetimibe versus high-intensity atorvastatin monotherapy in patients treated with percutaneous coronary intervention in practice: assessing RACING generalizability. Eur Heart J Cardiovasc Pharmacother 2023;10:676–685. [DOI] [PMC free article] [PubMed] [Google Scholar]
45. Kim B, Hong S, Lee Y, Hong SJ, Yun KH, Hong B, Heo JH, Rha S, Cho Y, Lee S, Ahn C, Kim J, Ko Y, Choi D, Jang Y, Hong M. Long-term efficacy and safety of moderate-intensity statin with ezetimibe combination therapy versus high-intensity statin monotherapy in patients with atherosclerotic cardiovascular disease (RACING): a randomised, open-label, non-inferiority trial. Lancet 2022;400:380–390. [DOI] [PubMed] [Google Scholar]
46. Schwartz GG, Steg PG, Szarek M, Bhatt DL, Bittner VA, Diaz R, Edelberg JM, Goodman SG, Hanotin C, Harrington RA, Jukema JW, Lecorps G, Mahaffey KW, Moryusef A, Pordy R, Quintero K, Roe MT, Sasiela WJ, Tamby J, Tricoci P, White HD, Zeiher AM. Alirocumab and cardiovascular outcomes after acute coronary syndrome. N Engl J Med 2018;379:2097–2107. [DOI] [PubMed] [Google Scholar]
47. Goodman SG, Steg PG, Szarek M, Bhatt DL, Bittner VA, Diaz R, Harrington RA, Jukema JW, White HD, Zeiher AM, Manvelian G, Pordy R, Poulouin Y, Stipek W, Garon G, Schwartz GG, Schwartz GG, Steg PG, Bhatt DL, Bittner VA, Diaz R, Goodman SG, Harrington RA, Jukema JW, Szarek M, White HD, Zeiher AM, Tricoci P, Roe MT, Mahaffey KW, Edelberg JM, Hanotin C, Lecorps G, Moryusef A, Pordy R, Sasiela WJ, Tamby J, Diaz R, Aylward PE, Drexel H, Sinnaeve P, Dilic M, Lopes RD, Gotcheva NN, Goodman SG, Prieto J, Yong H, López-Jaramillo P, Pećin I, Reiner Z, Ostadal P, Poulsen SH, Viigimaa M, Nieminen MS, Danchin N, Chumburidze V, Marx N, Liberopoulos E, Valdovinos PCM, Tse H, Kiss RG, Xavier D, Zahger D, Valgimigli M, Kimura T, Kim HS, Kim S, Erglis A, Laucevicius A, Kedev S, Yusoff K, López GAR, Alings M, White HD, Halvorsen S, Flores RMC, Sy RG, Budaj A, Morais J, Dorobantu M, Karpov Y, Ristic AD, Chua T, Murin J, Fras Z, Dalby AJ, Tuñón J, de Silva HA, Hagström E, Landmesser U, Chiang C, Sritara P, Guneri S, Parkhomenko A, Ray KK, Moriarty PM, Chaitman B, Kelsey SF, Olsson AG, Rouleau J, Simoons ML, Alexander K, Meloni C, Rosenson R, Sijbrands EJG, Tricoci P, Alexander JH, Armaganijan L, Bagai A, Bahit MC, Brennan JM, Clifton S, DeVore AD, Deloatch S, Dickey S, Dombrowski K, Ducrocq G, Eapen Z, Endsley P, Eppinger A, Harrison RW, Hess CN, Hlatky MA, Jordan JD, Knowles JW, Kolls BJ, Kong DF, Leonardi S, Lillis L, Lopes RD, Maron DJ, Mahaffey KW, Marcus J, Mathews R, Mehta RH, Mentz RJ, Patel CB, Pereira SB, Perkins L, Povsic TJ, Puymirat E, Roe MT, Jones WS, Shah BR, Sherwood MW, Stringfellow K, Sujjavanich D, Toma M, Trotter C, van Diepen SFP, Wilson MD, Yan AT, Schiavi LB, Garrido M, Alvarisqueta AF, Sassone SA, Bordonava AP, De Lima AEA, Schmidberg JM, Duronto EA, Caruso OC, Novaretto LP, Hominal MA, Montaña OR, Caccavo A, Vilamajo OAG, Lorenzatti AJ, Cartasegna LR, Paterlini GA, Mackinnon IJ, Caime GD, Amuchastegui M, Salomone O, Codutti OR, Jure HO, Bono JOE, Hrabar AD, Vallejos JA, Guerrero RAA, Novoa F, Patocchi CA, Zaidman CJ, Giuliano ME, Dran RD, Vico ML, Carnero GS, Guzman PN, Allende JCM, Brasca DFG, Labarta MHB, Nani S, Blumberg EDS, Colombo HR, Liberman A, Fuentealba V, Luciardi HL, Waisman GD, Berli MA, Garcia Duran RO, Cestari HG, Luquez HA, Giordano JA, Saavedra SS, Zapata G, Costamagna O, Llois S, Waites JH, Collins N, Soward A, Aylward PE, Hii CLS, Aylward PE, Shaw J, Arstall MA, Horowitz J, Ninio D, Rogers JF, Colquhoun D, Flores REO, Roberts-Thomson P, Raffel O, Lehman SJ, Aroney C, Coverdale SGM, Garrahy PJ, Starmer G, Sader M, Carroll PA, Dick R, Zweiker R, Hoppe U, Drexel H, Huber K, Berger R, Delle-Karth G, Frey B, Faes D, Hermans K, Pirenne B, Leone A, Hoffer E, Sinnaeve P, Vrolix MCM, De Wolf L, Wollaert B, Castadot M, Dujardin K, Beauloye C, Vervoort G, Striekwold H, Convens C, Roosen J, Barbato E, Claeys M, Cools F, Terzic I, Barakovic F, Midzic Z, Pojskic B, Fazlibegovic E, Dilic M, Durak-Nalbantic A, Kulić M, Vulic D, Muslibegovic A, Goronja B, Reis G, Sousa L, Nicolau JC, Giorgeto FE, Silva RP, Maia LN, Rech R, Rossi PRF, Cerqueira MJAG, Duda N, Kalil R, Kormann A, Abrantes JAM, Filho PP, Soggia AP, de Santos MON, Neuenschwander F, Bodanese LC, Michalaros YL, Eliaschewitz FG, Vidotti MH, Leaes PE, Botelho RV, Kaiser S, Manenti ERFF, Precoma DB, Jorge JCM, Silva P, Silveira JA, Saporito W, Neto JAM, Feitosa GS, Ritt LEF, de Souza JA, Costa F, Souza WKSB, Reis HJL, Lopes RD, Machado L, Ayoub JCA, Todorov GV, Nikolov FP, Velcheva ES, Tzekova ML, Benov HO, Petranov SL, Tumbev HS, Shehova-Yankova NS, Markov DT, Raev DH, Mollov MN, Kichukov KN, Ilieva-Pandeva KA, Gotcheva NN, Ivanova R, Gospodinov M, Mincheva VM, Lazov PV, Dimov BI, Senaratne M, Stone J, Kornder J, Dion D, Savard D, Pesant Y, Pandey A, Robinson S, Gosselin G, Vizel S, Hoag G, Bourgeois R, Morisset A, Sabbah E, Sussex B, Kouz S, MacDonald P, Diaz A, Michaud N, Fell D, Vuurmans T, Lai C, Nigro F, Davies R, Nogareda G, Vijayaraghavan R, Ducas J, Lepage S, Mehta S, Cha J, Dupuis R, Fong P, Lutchmedial S, Rodes-Cabau J, Fadlallah H, Cleveland D, Huynh T, Bata I, Hameed A, Pincetti C, Potthoff S, Prieto JC, Acevedo M, Aguirre A, Vejar M, Yañez M, Araneda G, Fernandez M, Perez L, Varleta P, Florenzano F, Huidobro L, Raffo CA, Olivares C, Nahuelpan L, Montecinos H, Chen J, Dong Y, Huang W, Wang J, Huang S, Yao Z, Li X, Cui L, Lin W, Sun Y, Wang J, Li J, Zhang X, Zhu H, Chen D, Huang L, Dong S, Su G, Xu B, Su X, Cheng X, Lin J, Zong W, Li H, Feng Y, Xu D, Yang X, Ke Y, Lin X, Zhang Z, Zheng Z, Luo Z, Chen Y, Ding C, Zhong Y, Zheng Y, Li X, Peng D, Zhao S, Li Y, Liu X, Wei M, Liu S, Yu Y, Qu B, Jiang W, Zhou Y, Zhao X, Yuan Z, Guo Y, Xu X, Shi X, Ge J, Fu G, Bai F, Fang W, Shou X, Yang X, Wang J, Xiang M, Sun Y, Lu Q, Zhang R, Zhu J, Xu Y, Fan Z, Li T, Wu C, Jaramillo N, Vallejo GS, Luna Botia DC, Lopez RB, Molina De Salazar DI, Cadena Bonfanti AJ, Aroca CC, Higuera JD, Blanquicett M, Barrera Silva SI, Lozada HJG, Coronel Arroyo JA, Accini Mendoza JL, Ruiz RLF, Quintero Ossa AM, Manzur Jatin FG, Herazo AS, Parada JC, Arambula RS, Triana MAU, Fernandez Trujillo AM, Strozzi M, Car S, Jerić M, Benčić ML, Pintarić H, Prvulović Đ, Šikić J, Peršić V, Mileta D, Štambuk K, Babić Z, Tomulic V, Lukenda J, Mejic-Krstulovic S, Starcevic B, Spinar J, Horak D, Velicka Z, Stasek J, Alan D, Machova V, Linhart A, Novotny V, Kaucak V, Rokyta R, Naplava R, Coufal Z, Adamkova V, Podpera I, Zizka J, Motovska Z, Marusincova I, Svab P, Ostadal P, Heinc P, Kuchar J, Povolny P, Matuska J, Poulsen SH, Raungaard B, Clemmensen P, Bang LE, May O, Bøttcher M, Hove JD, Frost L, Gislason G, Larsen J, Johansen PB, Hald F, Johansen P, Jeppesen J, Nielsen T, Kristensen KS, Walichiewicz PM, Lomholdt JD, Klausen IC, Nielsen PK, Davidsen F, Videbaek L, Viigimaa M, Soots M, Vahula V, Hedman A, Soopõld Ü, Märtsin K, Jurgenson T, Kristjan A, Nieminen MS, Huikuri H, Coste P, Ferrari E, Danchin N, Morel O, Montalescot G, Machecourt J, Barone-Rochette G, Mansourati J, Cottin Y, Steg PG, Leclercq F, Belhassane A, Delarche N, Boccara F, Paganelli F, Clerc J, Schiele F, Aboyans V, Probst V, Berland J, Lefèvre T, Citron B, Chumburidze V, Khintibidze I, Shaburishvili T, Pagava Z, Ghlonti R, Lominadze Z, Khabeishvili G, Hemetsberger R, Edward K, Rauch-Kröhnert U, Stratmann M, Appel K, Schmidt E, Omran H, Stellbrink C, Dorsel T, Lianopoulos E, Vöhringer HF, Marx R, Zirlik A, Schellenberg D, Heitzer T, Laufs U, Werner C, Marx N, Gielen S, Nuding S, Winkelmann B, Behrens S, Sydow K, Karakas M, Simonis G, Muenzel T, Werner N, Leggewie S, Böcker D, Braun-Dullaeus R, Toursarkissian N, Jeserich M, Weißbrodt M, Schaeufele T, Weil J, Völler H, Waltenberger J, Natour M, Schmitt S, Müller-Wieland D, Steiner S, Heidenreich L, Offers E, Gremmler U, Killat H, Rieker W, Patsilinakos S, Kartalis A, Manolis A, Sionis D, Chachalis G, Liberopoulos E, Skoumas I, Athyros V, Vardas P, Parthenakis F, Alexopoulos D, Hahalis G, Lekakis J, Hatzitolios A, Ovando SRF, Valdovinos PCM, Arango Benecke JL, Rodriguez De Leon ER, Yan BPY, Siu DCW, Turi T, Merkely B, Kiss RG, Ungi I, Lupkovics G, Nagy L, Katona A, Édes I, Müller G, Horvath I, Kapin T, Szigeti Z, Faluközy J, Kumbla M, Sandhu M, Annam S, Proddutur NR, Regella R, Premchand RK, Mahajan A, Pawar S, Abhyanakar AD, Kerkar P, Govinda RA, Oomman A, Sinha D, Patil SN, Kahali D, Sawhney J, Joshi AB, Chaudhary S, Harkut P, Guha S, Porwal S, Jujjuru S, Pothineni RB, Monteiro MR, Khan A, Iyengar SS, Grewal JS, Chopda M, Fulwani MC, Patange DA, Sachin P, Chopra VK, Goyal NK, Shinde R, Manakshe GV, Patki N, Sethi S, Munusamy V, Thanvi SKS, Adhyapak S, Patil C, Pandurangi U, Mathur R, Gupta J, Kalashetti S, Bhagwat A, Raghuraman B, Yerra SK, Bhansali P, Borse R, Rahul P, Das S, Kumar V, Abdullakutty J, Saathe S, Palimkar P, Abdullkutty J, Sathe S, Atar S, Shechter M, Mosseri M, Arbel Y, Ehud C, Ofer H, Lotan C, Rosenschein U, Katz A, Henkin Y, Francis A, Klutstein M, Nikolsky E, Zukermann R, Turgeman Y, Halabi M, Marmor A, Kornowski R, Jonas M, Amir O, Hasin Y, Rozenman Y, Fuchs S, Zvi V, Hussein O, Gavish D, Vered Z, Caraco Y, Elias M, Tov N, Wolfovitz E, Lishner M, Elias N, Piovaccari G, De Pellegrin A, Garbelotto R, Guardigli G, Marco V, Licciardello G, Auguadro C, Scalise F, Cuccia C, Salvioni A, Musumeci G, Senni M, Calabrò P, Novo S, Faggiano P, Metra M, De Cesare NB, Berti S, Cavallini C, Puccioni E, Galvani M, Tespili M, Piatti P, Palvarini M, De Luca G, Violini R, De Leo A, Olivari Z, Filardi PP, Ferratini M, Racca V, Dai K, Shimatani Y, Kamiya H, Ando K, Takeda Y, Morino Y, Hata Y, Kimura K, Kishi K, Michishita I, Uehara H, Higashikata T, Hirayama A, Hirooka K, Doi Y, Sakagami S, Taguchi S, Koike A, Fujinaga H, Koba S, Kozuma K, Kawasaki T, Ono Y, Shimizu M, Katsuda Y, Wada A, Shinke T, Kimura T, Ako J, Fujii K, Takahashi T, Sakamoto T, Nakao K, Furukawa Y, Sugino H, Tamura R, Mano T, Uematsu M, Utsu N, Ito K, Haraguchi T, Sato K, Ueda Y, Nishibe A, Fujimoto K, Masutani M, Nishibe A, Fujimoto K, Yoon JH, Kim S, Kim H, Park HS, Chae I, Kim MH, Jeong MH, Rha S, Kim C, Kim H, Kim HY, Hong T, Tahk S, Kim Y, Busmane A, Pontaga N, Strelnieks A, Mintale I, Sime I, Petrulioniene Z, Kavaliauskiene R, Jurgaitiene R, Sakalyte G, Slapikas R, Norkiene S, Misonis N, Kibarskis A, Kubilius R, Bojovski S, Kedev S, Lozance N, Kjovkaroski A, Doncovska S, Ong TK, Kasim S, Maskon O, Kandasamy B, Yusoff K, Liew HB, Mohamed WMIW, Castillo AG, López GAR, Calvillo JC, Campos PF, Fragoso JCN, Llamas EAB, Gamba MAA, Madrigal JC, Salas LGG, Rosas EL, Díaz BG, Vázquez ES, Ackar AN, Esperón GAL, Sánchez CRM, De Leon MG, Otero RS, Salmón GF, Ríos JAP, Ruíz JAG, Alings M, Breedveld RW, Feenema-Aardema M, Borger-Van Der Burg A, Hoogslag PAM, Suryapranata H, Oomen A, Van Haelst P, Feenema-Aradema M, Wiersma JJ, Basart D, Van Der Wal RMA, Zwart P, Monraats P, Van Kesteren H, Karalis I, Jukema J, Verdel GJE, Brueren BRG, Troquay RPTH, Viergever EP, Al-Windy NYY, Bartels GL, Cornel JH, Hermans WRM, Herrman JPR, Bos RJ, Groutars RGEJ, Van Der Zwaan CC, Kaplan R, Lionarons R, Ronner E, Groenemeijer BE, Bronzwaer PNA, Liem AAH, Rensing BJWM, Bokern MJJA, Nijmeijer R, Hersbach FMRJ, Willems FF, Gosselink ATM, Rasoul S, Elliott J, Wilkins G, Fisher R, Scott D, Hart H, Stewart R, Harding S, Ternouth I, Fisher N, Wilson S, Aitken D, Anscombe R, Davidson L, Tomala T, Nygård O, Sparby JA, Andersen K, Gullestad L, Jortveit J, Munk PS, Singsaas EG, Halvorsen S, Hurtig U, Correa Flores RM, Calderon Ticona JR, Velasquez JRD, Miguel SAN, Perez ESS, Carrion Chambilla JM, Chavez Ayala CA, Leon RPC, Vargas Gonzales RJ, Hernandez Zuniga JD, Cosavalente LAC, Bravo Mannucci JE, Landeo JH, Llerena Navarro NC, Concha YMR, Rodriguez Chavez VE, Anchante Hernandez HA, Zea Nunez CA, Ramos WM, Ferrolino A, Sy RAG, Tirador L, Sy RG, Matiga G, Coching RM, Bernan A, Rogelio G, Morales DD, Tan E, Sulit DJ, Wlodarczak A, Jaworska K, Skonieczny G, Pawlowicz L, Wojewoda P, Busz-Papiez B, Bednarski J, Goch A, Staneta P, Dulak E, Budaj A, Saminski K, Krasowski W, Sudnik W, Zurakowski A, Skorski M, Lysek R, Miklaszewicz B, Kubica J, Lipko JA, Kostarska-Srokosz E, Piepiorka M, Drzewiecka A, Sciborski R, Stasiewski A, Blicharski T, Bystryk L, Szpajer M, Korol M, Czerski T, Mirek-Bryniarska E, Gniot J, Lubinski A, Gorny J, Franek E, Raczak G, Szwed H, Monteiro P, Bastos JM, Pereira HH, Martins D, Morais J, Seixo F, Mendonça C, Botelho A, Caetano F, Minescu B, Istratoaie O, Tesloianu DN, Dorobantu M, Cristian G, Dumitrescu S, Podoleanu CGC, Constantinescu MCA, Bengus CM, Militaru C, Rosu D, Parepa IR, Matei AV, Alexandru TM, Malis M, Coman I, Stanescu-Cioranu R, Dimulescu D, Shvarts Y, Orlikova O, Kobalava Z, Barbarash OL, Markov V, Lyamina N, Gordienko A, Zrazhevsky K, Vishnevsky AY, Gurevich V, Stryuk R, Lomakin NV, Bokarev I, Khlevchuk T, Shalaev S, Khaisheva L, Chizhov P, Viktorova I, Osokina N, Shchekotov V, Akatova E, Chumakova G, Libov I, Voevoda MI, Tretyakova TV, Baranov E, Shustov S, Yakushin S, Gordeev I, Khasanov N, Reshetko O, Sotnikova T, Molchanova O, Nikolaev K, Gapon L, Baranova E, Shogenov Z, Kosmachova E, Karpov Y, Karpov Y, Povzun A, Egorova L, Tyrenko VV, Ivanov IG, Ilya M, Kanorsky S, Simic D, Ivanovic N, Davidovic G, Tasic N, Asanin MR, Stojic S, Apostolovic SR, Ilic S, Tosic BP, Stankovic A, Arandjelovic A, Radovanovic S, Todic B, Ristic AD, Balinovac J, Dincic DV, Seferovic P, Karadzic A, Dodic S, Dimkovic S, Jakimov T, Chua T, Poh K, Ong HY, Tang I-Shing J, Micko K, Nociar J, Pella D, Fulop P, Hranai M, Palka J, Mazur J, Majercák I, Dzupina A, Fazekas F, Gonsorcik J, Bugan V, Murin J, Selecky J, Kamensky G, Strbova J, Smik R, Dukat A, Olexa P, Žuran I, Poklukar J, Šuligoj NČ, Cevc M, Fras Z, Cyster HP, Ranjith N, Corbett C, Bayat J, Makotoko EM, du Toit Theron H, Kapp IE, de V Basson MM, Lottering H, Van Aswegen D, Van Zyl LJ, Sebastian PJ, Pillay T, Saaiman JA, Commerford PJ, Cassimjee S, Riaz G, Ebrahim IO, Sarvan M, Mynhardt JH, Dalby AJ, Reuter H, Moodley R, Vida M, Cequier Fillat AR, Peris VB, Jimenez FF, Marín F, Fernández JMC, Urbano RJH, Gil-Extremera B, Toledo P, Diz FW, Garcia-Dorado D, Iñiguez A, Fernández JT, Gonzalez-Juanatey JR, Portales JF, Murillo FC, Pericas LM, Zamorano JL, Martin MDM, Cortada JB, Alonso Martin JJ, Antolin JMS, De Berrazueta Fernández JR, de Prada JAV, Fernández JFD, Lledó JAG, Sales JC, Rodriguez JB, Tragant GG, Benedicto A, Gonzalez-Juanatey C, Potau MC, Perez IP, De La Tassa CM, Rincon PL, Recena JB, Escudier JM, Payeras AC, Orcajo NA, Valdivielso P, Constantine G, Haniffa R, Tissera N, Amarasekera S, Ponnamperuma C, Fernando N, Fernando K, Jayawardena J, Wijeyasingam S, Ranasinghe G, Ekanayaka R, Mendis S, Senaratne V, Mayurathan G, Rajapaksha A, Sirisena T, Herath JI, Amarasena N, Berglund S, Rasmanis G, Hagström E, Vedin O, Witt N, Mourtzinis G, Nicol P, Hansen O, Romeo S, Jensen SA, Torstensson I, Ahremark U, Sundelin T, Moccetti T, Müller C, Mach F, Binde R, Landmesser U, Gämperli O, Chiang C, Tsai W, Ueng K, Lai W, Liu M, Hwang J, Yin W, Hsieh I, Hsieh M, Lin WH, Kuo J, Huang T, Fang C, Kaewsuwanna P, Soonfuang W, Jintapakorn W, Sukonthasarn A, Sritara P, Wongpraparut N, Sastravaha K, Sansanayudh N, Kehasukcharoen W, Piyayotai D, Chotnoparatpat P, Camsari A, Kultursay H, Guneri S, Mutlu B, Ersanli M, Demirtas M, Kirma C, Ural E, Koldas L, Karpenko O, Prokhorov A, Vakaluyk I, Myshanych H, Reshotko D, Batushkin V, Rudenko L, Kovalskyi I, Kushnir M, Tseluyko V, Mostovoy Y, Stanislavchuk M, Kyiak Y, Karpenko Y, Malynovsky Y, Klantsa A, Kutniy O, Amosova E, Tashchuk V, Leshchuk O, Parkhomenko A, Rishko M, Kopytsya M, Yagensky A, Vatutin M, Bagriy A, Barna OM, Ushakov O, Dzyak G, Goloborodko B, Rudenko A, Zheleznyy V, Trevelyan J, Zaman A, Lee K, Moriarty A, Aggarwal RK, Clifford P, Wong Y, Iqbal SMR, Subkovas E, Braganza D, Sarkar D, Storey R, Griffiths H, Mcclure S, Muthusamy R, Smith S, Kurian J, Levy T, Barr C, Kadr H, Gerber R, Simaitis A, Soran H, Mathur A, Brodison A, Ayaz M, Cheema M, Oliver R, Thackray S, Mudawi T, Rahman G, Sultan A, Reynolds T, Sharman D, Sprigings D, Butler R, Wilkinson P, Lip GYH, Halcox J, Gallagher S, Ossei-Gerning N, Vardi G, Baldari D, Brabham D, Treasure C, Dahl C, Palmer B, Wiseman A, Khan A, Puri S, Mohart AE, Ince C, Flores E, Wright S, Cheng S, Rosenberg M, Rogers W, Kosinski E, Forgosh L, Waltman J, Khan M, Shoukfeh M, Dagher G, Cambier P, Lieber I, Kumar P, East C, Krichmar P, Hasan M, White L, Knickelbine T, Haldis T, Gillespie E, Amidon T, Suh D, Arif I, Abdallah M, Akhter F, Carlson E, D'Urso M, El-Ahdab F, Nelson W, Moriarty K, Harris B, Cohen S, Carter L, Doty D, Sabatino K, Haddad T, Malik A, Rao S, Mulkay A, Jovin I, Klancke K, Malhotra V, Devarapalli SK, Koren M, Chandna H, Dodds G, Goraya T, Bengston J, Janik M, Moran J, Sumner A, Kobayashi J, Davis W, Yazdani S, Pasquini J, Thakkar M, Vedere A, Leimbach W, Rider J, fenton S, Singh N, Shah AV, Moriarty PM, Janosik D, Pepine C, Berman B, Gelormini J, Daniels C, Richard K, Keating F, Kondo NI, Shetty S, Levite H, Waider W, Takata T, Abu-Fadel M, Shah V, Aggarwal R, Izzo M, Kumar A, Hattler B, Do R, Link C, Bortnick A, Kinzfogl G, Ghitis A, Larry J, Teufel E, Kuhlman P, Mclaurin B, Zhang W, Thew S, Abbas J, White M, Islam O, Subherwal S, Ranadive N, Vakili B, Gring C, Henderson D, Schuchard T, Farhat N, Kline G, Mahal S, Whitaker J, Speirs S, Andersen R, Daboul N, Horwitz P, Zahr F, Ponce G, Jafar Z, Mcgarvey J, Panchal V, Voyce S, Blok T, Sheldon W, Azizad MM, Schmalfuss C, Picone M, Pederson R, Herzog W, Friedman K, Lindsey J, Nowins R, Timothy E, Leonard P, Lepor N, El Shahawy M, Weintraub H, Irimpen A, Alonso A, May W, Christopher D, Galski T, Chu A, Mody F, Ramin E, Hodes Z, Rossi J, Rose G, Fairlamb J, Lambert C, Raisinghani A, Abbate A, Vetrovec G, King M, Carey C, Gerber J, Younis L, Park H, Vidovich M, Knutson T, Friedman D, Chaleff F, Loussararian A, Rozeman P, Kimmelstiel C, Kuvin J, Silver K, Foster M, Tonnessen G, Espinoza A, Amlani M, Wali A, Malozzi C, Jong GT, Massey C, Wattanakit K, O'Donnell PJ, Singal D, Jaffrani N, Banuru S, Fisher D, Xenakis M, Perlmutter N, Bhagwat R, Strader J, Blonder R, Akyea-Djamson A, Labroo A, Lee K, Marais HJ, Claxton E, Weiss R, Kathryn R, Berk M, Rossi P, Joshi P, Khera A, Khaira AS, Kumkumian G, Lupovitch S, Purow J, Welka S, Hoffman D, Fischer S, Soroka E, Eagerton D, Pancholy S, Ray M, Erenrich N, Farrar M, Pollock S, French WJ, Diamantis S, Guy D, Gimple L, Neustel M, Schwartz S, Pereira E, Albert S, Spriggs D, Strain J, Mittal S, Vo A, Chane M, Hall J, Vijay N, Lotun K, Lester FM, Nahhas A, Pope T, Nager P, Vohra R, Sharma M, Bashir R, Ahmed H, Berlowitz M, Fishberg R, Barrucco R, Yang E, Radin M, Sporn D, Stapleton D, Eisenberg S, Landzberg J, Mcgough M, Turk S, Schwartz M, Sundram PS, Jain D, Zainea M, Bayron C, Karlsberg R, Dohad S, Lui H, Keen W, Westerhausen D, Khurana S, Agarwal H, Birchem J, Penny W, Chang M, Murphy S, Henry J, Schifferdecker B, Gilbert JM, Chalavarya G, Eaton C, Schmedtje JF, Christenson S, Dotani I, Denham D, Macdonell A, Gibson P, Rahman A, Joundi TA, Assi N, Conrad G, Kotha P, Love M, Giesler G, Rubenstein H, Gamil D, Akright L, Krawczyk J, Cobler J, Wells T, Welker J, Foster R, Gilmore R, Anderson J, Jacoby D, Harris B, Gardner G, Dandillaya R, Vora K, Kostis J, Hunter J, Laxson D, Ball E, Anderson J, Wells T, Vora K, Ball E, Welker J, Lopes RD, Egydio F, Kawakami A, Oliveira J, Goodman SG, Wozniak J, Matthews A, Ratky C, Valiris J, Berdan L, Hepditch A, Quintero K, Roe MT, Rorick T, Westbrook M, Diaz R, Pascual A, Rovito C, Danchin N, Bezault M, Drouet E, Simon T, White HD, Alsweiler C, Sinnaeve P, Luyten A, Aylward PE, Butters J, Griffith L, Shaw M, Hagström E, Grunberg L, Szarek M, Islam S, Brégeault M, Bougon N, Faustino D, Fontecave S, Murphy J, Tamby J, Verrier M, Agnetti V, Andersen D, Badreddine E, Bekkouche M, Bouancheau C, Brigui I, Brocklehurst M, Cianciarulo J, Devaul D, Domokos S, Gache C, Gobillot C, Guillou S, Healy J, Heath M, Jaiwal G, Javierre C, Labeirie J, Monier M, Morales U, Mrabti A, Mthombeni B, Okan B, Smith L, Sheller J, Sopena S, Pellan V, Benbernou F, Bengrait N, Lamoureux M, Kralova K, Scemama M, Bejuit R, Coulange A, Berthou C, Repincay J, Lorenzato C, Etienne A, Gouet V, Lecorps G, Loizeau V, Normand M, Ourliac A, Rondel C, Adamo A, Beltran P, Barraud P, Dubois-Gache H, Halle B, Metwally L, Mourgues M, Sotty M, Vincendet M, Cotruta R, Chengyue Z, Fournie-Lloret D, Morrello C, Perthuis A, Picault P, Zobouyan I, Colhoun HM, Dempsey MA, McClanahan MA. Safety of the PCSK9 inhibitor alirocumab: insights from 47 296 patient-years of observation. Eur Heart J Cardiovasc Pharmacother 2024;10:342–352. [DOI] [PMC free article] [PubMed] [Google Scholar]
48. Ganda OP, Plutzky J, Sanganalmath SK, Bujas‐Bobanovic M, Koren A, Mandel J, Letierce A, Leiter LA. Efficacy and safety of alirocumab among individuals with diabetes mellitus and atherosclerotic cardiovascular disease in the ODYSSEY phase 3 trials. Diabetes Obes Metab 2018;20:2389–2398. [DOI] [PMC free article] [PubMed] [Google Scholar]
49. Sabatine MS, Giugliano RP, Keech AC, Honarpour N, Wiviott SD, Murphy SA, Kuder JF, Wang H, Liu T, Wasserman SM, Sever PS, Pedersen TR. Evolocumab and clinical outcomes in patients with cardiovascular disease. N Engl J Med 2017;376:1713–1722. [DOI] [PubMed] [Google Scholar]
50. Sabatine MS, Leiter LA, Wiviott SD, Giugliano RP, Deedwania P, De Ferrari GM, Murphy SA, Kuder JF, Gouni-Berthold I, Lewis BS, Handelsman Y, Pineda AL, Honarpour N, Keech AC, Sever PS, Pedersen TR. Cardiovascular safety and efficacy of the PCSK9 inhibitor evolocumab in patients with and without diabetes and the effect of evolocumab on glycaemia and risk of new-onset diabetes: a prespecified analysis of the FOURIER randomised controlled trial. Lancet Diabetes Endocrinol 2017;5:941–950. [DOI] [PubMed] [Google Scholar]
51. Imbalzano E, Ilardi F, Orlando L, Pintaudi B, Savarese G, Rosano G. The efficacy of PCSK9 inhibitors on major cardiovascular events and lipid profile in patients with diabetes: a systematic review and meta-analysis of randomized controlled trials. Eur Heart J Cardiovasc Pharmacother 2023;9:318–327. [DOI] [PubMed] [Google Scholar]
52. Leiter LA, Cariou B, Müller‐Wieland D, Colhoun HM, Del Prato S, Tinahones FJ, Ray KK, Bujas‐Bobanovic M, Domenger C, Mandel J, Samuel R, Henry RR. Efficacy and safety of alirocumab in insulin-treated individuals with type 1 or type 2 diabetes and high cardiovascular risk: the ODYSSEY DM-INSULIN randomized trial. Diabetes Obes Metab 2017;19:1781–1792. [DOI] [PMC free article] [PubMed] [Google Scholar]
53. Mercep I, Strikic D, Hrabac P, Pecin I, Reiner Z. PCSK9 inhibition: from effectiveness to cost-effectiveness. Front Cardiovasc Med 2024;11:1339487. [DOI] [PMC free article] [PubMed] [Google Scholar]
54. Nissen SE, Lincoff AM, Brennan D, Ray KK, Mason D, Kastelein JJ, Thompson PD, Libby P, Cho L, Plutzky J, Bays HE, Moriarty PM, Menon V, Grobbee DE, Louie MJ, Chen C, Li N, Bloedon L, Robinson P, Horner M, Sasiela WJ, McCluskey J, Davey D, Fajardo-Campos P, Petrovic P, Fedacko J, Zmuda W, Lukyanov Y, Nicholls SJ. Bempedoic acid and cardiovascular outcomes in statin-intolerant patients. N Engl J Med 2023;388:1353–1364. [DOI] [PubMed] [Google Scholar]
55. Jo SH, Nam H, Lee J, Park S, Lee J, Kyoung DS. Fenofibrate use is associated with lower mortality and fewer cardiovascular events in patients with diabetes: results of 10,114 patients from the Korean National Health Insurance Service cohort. Diabetes Care 2021;44:1868–1876. [DOI] [PubMed] [Google Scholar]
56. Agewall S. New data on NOVEL ORAL ANTICOAGULANT, SGLT2i, lipid treatment and genetics. Eur Heart J Cardiovasc Pharmacother 2024;10:83–84. [DOI] [PubMed] [Google Scholar]
57. LENS Collaborative Group . Design, recruitment and baseline characteristics of the LENS trial. Diabet Med 2024;41:e15310. [DOI] [PMC free article] [PubMed] [Google Scholar]
58. Hostrup PE, Schmidt T, Hellsten SB, Gerwig RH, Størling J, Johannesen J, Sulek K, Hostrup M, Andersen HU, Buschard K, Hamid Y, Pociot F. Effect of fenofibrate on residual beta cell function in adults and adolescents with newly diagnosed type 1 diabetes: a randomised clinical trial. Diabetologia 2025;68:29–40. [DOI] [PMC free article] [PubMed] [Google Scholar]
59. O'Mahoney LL, Dunseath G, Churm R, Holmes M, Boesch C, Stavropoulos-Kalinoglou A, Ajjan RA, Birch KM, Orsi NM, Mappa G, Price OJ, Campbell MD. Omega-3 polyunsaturated fatty acid supplementation versus placebo on vascular health, glycaemic control, and metabolic parameters in people with type 1 diabetes: a randomised controlled preliminary trial. Cardiovasc Diabetol 2020;19:127. [DOI] [PMC free article] [PubMed] [Google Scholar]
60. Drexel H, Pocock SJ, Lewis BS, Saely CH, Kaski JC, Rosano GMC, Tautermann G, Huber K, Dopheide JF, Mader A, Niessner A, Savarese G, Schmidt TA, Semb AG, Tamargo J, Wassmann S, Clodi M, Kjeldsen KP, Agewall S. Subgroup analyses in randomized clinical trials: value and limitations. Review #3 on important aspects of randomized clinical trials in cardiovascular pharmacotherapy. Eur Heart J Cardiovasc Pharmacother 2022;8:302–310. [DOI] [PubMed] [Google Scholar]
61. Patti G, Spinoni EG, Grisafi L, Mehran R, Mennuni M. Safety and efficacy of very low LDL-cholesterol intensive lowering: a meta-analysis and meta-regression of randomized trials. Eur Heart J Cardiovasc Pharmacother 2023;9:138–147. [DOI] [PubMed] [Google Scholar]

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Data Availability Statement

No new data were generated or analysed in support of this research.

[bib1] 1. Rawshani A, Sattar N, Franzen S, Rawshani A, Hattersley AT, Svensson AM, Eliasson B, Gudbjörnsdottir S. Excess mortality and cardiovascular disease in young adults with type 1 diabetes in relation to age at onset: a nationwide, register-based cohort study. Lancet 2018;392:477–486. [DOI] [PMC free article] [PubMed] [Google Scholar]

[bib2] 2. Rawshani A, Rawshani A, Gudbjornsdottir S. Mortality and cardiovascular disease in type 1 and type 2 diabetes. N Engl J Med 2017;377:300–301. [DOI] [PubMed] [Google Scholar]

[bib3] 3. Manrique-Acevedo C, Hirsch IB, Eckel RH. Prevention of cardiovascular disease in type 1 diabetes. Reply. N Engl J Med 2024;390:2227. [DOI] [PubMed] [Google Scholar]

[bib4] 4. Morrish NJ, Wang SL, Stevens LK, Fuller JH, Keen H. Mortality and causes of death in the WHO Multinational Study of Vascular Disease in Diabetes. Diabetologia 2001;44:S14–S21. [DOI] [PubMed] [Google Scholar]

[bib5] 5. Huxley RR, Peters SA, Mishra GD, Woodward M. Risk of all-cause mortality and vascular events in women versus men with type 1 diabetes: a systematic review and meta-analysis. Lancet Diabetes Endocrinol 2015;3:198–206. [DOI] [PubMed] [Google Scholar]

[bib6] 6. Vergès B. Cardiovascular disease in type 1 diabetes, an underestimated danger: epidemiological and pathophysiological data. Atherosclerosis 2024;394:117158. [DOI] [PubMed] [Google Scholar]

[bib7] 7. Bebu I, Braffett BH, Pop-Busui R, Orchard TJ, Nathan DM, Lachin JM, DCCT/EDIC Research Group . The relationship of blood glucose with cardiovascular disease is mediated over time by traditional risk factors in type 1 diabetes: the DCCT/EDIC study. Diabetologia 2017;60:2084–2091. [DOI] [PMC free article] [PubMed] [Google Scholar]

[bib8] 8. Miller RG, Orchard TJ, Costacou T. Risk factors differ by first manifestation of cardiovascular disease in type 1 diabetes. Diabetes Res Clin Pract 2020;163:108141. [DOI] [PMC free article] [PubMed] [Google Scholar]

[bib9] 9. Orchard TJ, Forrest KY, Kuller LH, Becker DJ, Pittsburgh Epidemiology of Diabetes Complications, S . Lipid and blood pressure treatment goals for type 1 diabetes: 10-year incidence data from the Pittsburgh Epidemiology of Diabetes Complications Study. Diabetes Care 2001;24:1053–1059. [DOI] [PubMed] [Google Scholar]

[bib10] 10. Hero C, Svensson A, Gidlund P, Gudbjörnsdottir S, Eliasson B, Eeg-Olofsson K. LDL cholesterol is not a good marker of cardiovascular risk in type 1 diabetes. Diabet Med 2016;33:316–323. [DOI] [PubMed] [Google Scholar]

[bib11] 11. Hero C, Karlsson SA, Franzén S, Svensson A, Miftaraj M, Gudbjörnsdottir S, Andersson Sundell K, Eliasson B, Eeg-Olofsson K. Adherence to lipid-lowering therapy and risk for cardiovascular disease and death in type 1 diabetes mellitus: a population-based study from the Swedish National Diabetes Register. BMJ Open Diabetes Res Care 2020;8:e000719. [DOI] [PMC free article] [PubMed] [Google Scholar]

[bib12] 12. Hughes TA, Calderon RM, Diaz S, Mendez AJ, Goldberg RB. Lipoprotein composition in patients with type 1 diabetes mellitus: impact of lipases and adipokines. J Diabetes Complications 2016;30:657–668. [DOI] [PubMed] [Google Scholar]

[bib13] 13. Vergès B. Dyslipidemia in type 1 diabetes: a masked danger. Trends Endocrinol Metab 2020;31:422–434. [DOI] [PubMed] [Google Scholar]

[bib14] 14. Writing Group for the, D. E. R. G . Coprogression of cardiovascular risk factors in type 1 diabetes during 30 years of follow-up in the DCCT/EDIC study. Diabetes Care 2016;39:1621–1630. [DOI] [PMC free article] [PubMed] [Google Scholar]

[bib15] 15. Nathan DM, Cleary PA, Backlund JY, Genuth SM, Lachin JM, Orchard TJ, Raskin P, Zinman B, Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study Research Group . Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N Engl J Med 2005;353:2643–2653. [DOI] [PMC free article] [PubMed] [Google Scholar]

[bib16] 16. Rawshani A, Rawshani A, Franzén S, Eliasson B, Svensson A, Miftaraj M, McGuire DK, Sattar N, Rosengren A, Gudbjörnsdottir S. Range of risk factor levels: control, mortality, and cardiovascular outcomes in type 1 diabetes mellitus. Circulation 2017;135:1522–1531. [DOI] [PMC free article] [PubMed] [Google Scholar]

[bib17] 17. Kim SE, Han K, Cho WK, Suh BK. Cardiovascular complications, kidney failure, and mortality in young-onset type 1 and type 2 diabetes: data from the Korean National Health Insurance Service. Diabetes Care 2025;48:422–429. [DOI] [PubMed] [Google Scholar]

[bib18] 18. Tardif J, Kouz S, Waters DD, Bertrand OF, Diaz R, Maggioni AP, Pinto FJ, Ibrahim R, Gamra H, Kiwan GS, Berry C, López-Sendón J, Ostadal P, Koenig W, Angoulvant D, Grégoire JC, Lavoie M, Dubé M, Rhainds D, Provencher M, Blondeau L, Orfanos A, L'Allier PL, Guertin M, Roubille F. Efficacy and safety of low-dose colchicine after myocardial infarction. N Engl J Med 2019;381:2497–2505. [DOI] [PubMed] [Google Scholar]

[bib19] 19. Nidorf SM, Fiolet AT, Mosterd A, Eikelboom JW, Schut A, Opstal TS, The SH, Xu X, Ireland MA, Lenderink T, Latchem D, Hoogslag P, Jerzewski A, Nierop P, Whelan A, Hendriks R, Swart H, Schaap J, Kuijper AF, van Hessen MW, Saklani P, Tan I, Thompson AG, Morton A, Judkins C, Bax WA, Dirksen M, Alings M, Hankey GJ, Budgeon CA, Tijssen JG, Cornel JH, Thompson PL, LoDoCo2 Trial Investigators . Colchicine in patients with chronic coronary disease. N Engl J Med 2020;383:1838–1847. [DOI] [PubMed] [Google Scholar]

[bib20] 20. Johansen NJ, Knop FK. The potential of colchicine for lowering the risk of cardiovascular events in type 1 diabetes. Eur Heart J Cardiovasc Pharmacother 2023;9:311–317. [DOI] [PubMed] [Google Scholar]

[bib21] 21. Agewall S. Focus on prevention in diabetes mellitus and lipid disorder. Eur Heart J Cardiovasc Pharmacother 2023;9:295–296 [DOI] [PubMed] [Google Scholar]

[bib22] 22. Lawler PR, Bhatt DL, Godoy LC, Lüscher TF, Bonow RO, Verma S, Ridker PM. Targeting cardiovascular inflammation: next steps in clinical translation. Eur Heart J 2021;42:113–131. [DOI] [PubMed] [Google Scholar]

[bib23] 23. Stroes ES, Bays HE, Banach M, Catapano AL, Duell PB, Laufs U, Mancini GJ, Ray KK, Sasiela WJ, Zhang Y, Gotto AM. Bempedoic acid lowers high-sensitivity C-reactive protein and low-density lipoprotein cholesterol: analysis of pooled data from four phase 3 clinical trials. Atherosclerosis 2023;373:1–9. [DOI] [PubMed] [Google Scholar]

[bib24] 24. Conrad N, Verbeke G, Molenberghs G, Goetschalckx L, Callender T, Cambridge G, Mason JC, Rahimi K, McMurray JJV, Verbakel JY. Autoimmune diseases and cardiovascular risk: a population-based study on 19 autoimmune diseases and 12 cardiovascular diseases in 22 million individuals in the UK. Lancet 2022;400:733–743. [DOI] [PubMed] [Google Scholar]

[bib25] 25. Mohammedi K, Marre M, Alhenc-Gelas F. Genetic predisposition to nephropathy and associated cardiovascular disease in people with type 1 diabetes: role of the angiotensinI-converting enzyme (ACE), and beyond; a narrative review. Cardiovasc Diabetol 2024;23:453. [DOI] [PMC free article] [PubMed] [Google Scholar]

[bib26] 26. Vistisen D, Andersen GS, Hansen CS, Hulman A, Henriksen JE, Bech-Nielsen H, Jørgensen ME. Prediction of first cardiovascular disease event in type 1 diabetes mellitus: the steno type 1 risk engine. Circulation 2016;133:1058–1066. [DOI] [PubMed] [Google Scholar]

[bib27] 27. Miller RG, Costacou T, Orchard TJ. Risk factor modeling for cardiovascular disease in type 1 diabetes in the Pittsburgh Epidemiology of Diabetes Complications (EDC) study: a comparison with the diabetes control and complications trial/Epidemiology of Diabetes interventions and complications study (DCCT/EDIC). Diabetes 2019;68:409–419. [DOI] [PMC free article] [PubMed] [Google Scholar]

[bib28] 28. Zgibor JC, Piatt GA, Ruppert K, Orchard TJ, Roberts MS. Deficiencies of cardiovascular risk prediction models for type 1 diabetes. Diabetes Care 2006;29:1860–1865. [DOI] [PubMed] [Google Scholar]

[bib29] 29. Helleputte S, Van Bortel L, Verbeke F, Op ‘t Roodt J, Calders P, Lapauw B, De Backer T. Arterial stiffness in patients with type 1 diabetes and its comparison to cardiovascular risk evaluation tools. Cardiovasc Diabetol 2022;21:97. [DOI] [PMC free article] [PubMed] [Google Scholar]

[bib30] 30. Battistoni A, Michielon A, Marino G, Savoia C. Vascular aging and Central aortic blood pressure: from pathophysiology to treatment. High Blood Press Cardiovasc Prev 2020;27:299–308. [DOI] [PubMed] [Google Scholar]

[bib31] 31. González-Clemente J, Cano A, Albert L, Giménez-Palop O, Romero A, Berlanga E, Vendrell J, Llauradó G. Arterial stiffness in type 1 diabetes: the case for the arterial wall itself as a target organ. J Clin Med 2021;10:3616. [DOI] [PMC free article] [PubMed] [Google Scholar]

[bib32] 32. Zaccardi F, Rizzi A, Petrucci G, Ciaffardini F, Tanese L, Pagliaccia F, Cavalca V, Ciminello A, Habib A, Squellerio I, Rizzo P, Tremoli E, Rocca B, Pitocco D, Patrono C. In vivo platelet activation and aspirin responsiveness in type 1 diabetes. Diabetes 2016;65:503–509. [DOI] [PubMed] [Google Scholar]

[bib33] 33. Zaccardi F, Rocca B, Rizzi A, Ciminello A, Teofili L, Ghirlanda G, De Stefano V, Pitocco D. Platelet indices and glucose control in type 1 and type 2 diabetes mellitus: a case-control study. Nutr Metab Cardiovasc Dis 2017;27:902–909. [DOI] [PubMed] [Google Scholar]

[bib34] 34. Hero C, Rawshani A, Svensson A, Franzén S, Eliasson B, Eeg-Olofsson K, Gudbjörnsdottir S. Association between use of lipid-lowering therapy and cardiovascular diseases and death in individuals with type 1 diabetes. Diabetes Care 2016;39:996–1003. [DOI] [PubMed] [Google Scholar]

[bib35] 35. Marx N, Federici M, Schütt K, Müller-Wieland D, Ajjan RA, Antunes MJ, Christodorescu RM, Crawford C, Di Angelantonio E, Eliasson B, Espinola-Klein C, Fauchier L, Halle M, Herrington WG, Kautzky-Willer A, Lambrinou E, Lesiak M, Lettino M, McGuire DK, Mullens W, Rocca B, Sattar N, Prescott E, Cosentino F, Abdelhamid M, Aboyans V, Antoniou S, Asteggiano R, Baumgartner I, Buccheri S, Bueno H, Čelutkienė J, Chieffo A, Christersson C, Coats A, Cosyns B, Czerny M, Deaton C, Falk V, Ference BA, Filippatos G, Fisher M, Huikuri H, Ibanez B, Jaarsma T, James S, Khunti K, Køber L, Koskinas KC, Lewis BS, Løchen M, McEvoy JW, Mihaylova B, Mindham R, Neubeck L, Nielsen JC, Parati G, Pasquet AA, Patrono C, Petersen SE, Piepoli MF, Rakisheva A, Rossello X, Rossing P, Rydén L, Standl E, Tokgozoglu L, Touyz RM, Visseren F, Volpe M, Vrints C, Witkowski A, Hazarapetyan L, Zirlik A, Rustamova Y, van de Borne P, Sokolović Š, Gotcheva N, Milicic D, Agathangelou P, Vrablík M, Schou M, Hasan-Ali H, Viigimaa M, Lautamäki R, Aboyans V, Klimiashvili Z, Kelm M, Siasos G, Kiss RG, Libungan B, Durkan M, Zafrir B, Colivicchi F, Tundybayeva M, Bytyçi I, Mirrakhimov E, Trusinskis K, Saadé G, Badarienė J, Banu C, Magri CJ, Boskovic A, Hattaoui ME, Martens F, Bosevski M, Knudsen EC, Burchardt P, Fontes-Carvalho R, Vinereanu D, Mancini T, Beleslin B, Martinka E, Fras Z, Conde AC, Mellbin L, Carballo D, Bsata W, Mghaieth F, Gungor B, Mitchenko O, Wheatcroft S, Trigulova R, Prescott E, James S, Arbelo E, Baigent C, Borger MA, Buccheri S, Ibanez B, Køber L, Koskinas KC, McEvoy JW, Mihaylova B, Mindham R, Neubeck L, Nielsen JC, Pasquet AA, Rakisheva A, Rocca B, Rosselló X, Vaartjes I, Vrints C, Witkowski A, Zeppenfeld K. 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes. Eur Heart J 2023;44:4043–4140. [DOI] [PubMed] [Google Scholar]

[bib36] 36. Cholesterol Treatment Trialists' (CTT) Collaborators, Kearney PM, Blackwell L, Collins R, Keech A, Simes J, Peto R, Armitage J, Baigent C Efficacy of cholesterol-lowering therapy in 18,686 people with diabetes in 14 randomised trials of statins: a meta-analysis. Lancet 2008;371:117–125. [DOI] [PubMed] [Google Scholar]

[bib37] 37. Yoo J, Jeon J, Baek M, Song SO, Kim J. Impact of statin treatment on cardiovascular risk in patients with type 1 diabetes: a population-based cohort study. J Transl Med 2023;21:806. [DOI] [PMC free article] [PubMed] [Google Scholar]

[bib38] 38. Cholesterol Treatment Trialists, C . Effect of statin therapy on muscle symptoms: an individual participant data meta-analysis of large-scale, randomised, double-blind trials. Lancet 2022;400:832–845. [DOI] [PMC free article] [PubMed] [Google Scholar]

[bib39] 39. Cholesterol Treatment Trialists' Collaboration. Electronic address, c. n. o. a. u., and Cholesterol Treatment Trialists, C . Effects of statin therapy on diagnoses of new-onset diabetes and worsening glycaemia in large-scale randomised blinded statin trials: an individual participant data meta-analysis. Lancet Diabetes Endocrinol 2024;12:306–319. [DOI] [PMC free article] [PubMed] [Google Scholar]

[bib40] 40. Duvnjak L, Blaslov K. Statin treatment is associated with insulin sensitivity decrease in type 1 diabetes mellitus: a prospective, observational 56-month follow-up study. J Clin Lipidol 2016;10:1004–1010. [DOI] [PubMed] [Google Scholar]

[bib41] 41. Niechciał E, Acerini CL, Chiesa ST, Stevens T, Dalton RN, Daneman D, Deanfield JE, Jones TW, Mahmud FH, Marshall SM, Neil HAW, Dunger DB, Marcovecchio ML, Acerini CL, Ackland F, Anand B, Barrett T, Birrell V, Campbell F, Charakida M, Cheetham T, Chiesa ST, Deanfield JE, Cooper C, Doughty I, Dutta A, Edge J, Gray A, Hamilton-Shield J, Mann N, Marcovecchio ML, Marshall SM, Neil HAW, Rayman G, Robinson JM, Russell-Taylor M, Sankar V, Smith A, Thalange N, Yaliwal C, Benitez-Aguirre P, Cameron F, Cotterill A, Couper J, Craig M, Davis E, Donaghue K, Jones TW, King B, Verge C, Bergman P, Rodda C, Clarson C, Curtis J, Daneman D, Mahmud FH, Sochett E. Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial (AdDIT) Study Group; Adolescent Type 1 Diabetes Cardio-renal Intervention Trial AdDIT Study Group . Medication adherence during adjunct therapy with statins and ACE inhibitors in adolescents with type 1 diabetes. Diabetes Care 2020;43:1070–1076. [DOI] [PMC free article] [PubMed] [Google Scholar]

[bib42] 42. Cannon CP, Blazing MA, Giugliano RP, McCagg A, White JA, Theroux P, Darius H, Lewis BS, Ophuis TO, Jukema JW, De Ferrari GM, Ruzyllo W, De Lucca P, Im K, Bohula EA, Reist C, Wiviott SD, Tershakovec AM, Musliner TA, Braunwald E, Califf RM. Ezetimibe added to statin therapy after acute coronary syndromes. N Engl J Med 2015;372:2387–2397. [DOI] [PubMed] [Google Scholar]

[bib43] 43. Giugliano RP, Cannon CP, Blazing MA, Nicolau JC, Corbalán R, Špinar J, Park J, White JA, Bohula EA, Braunwald E. Benefit of adding ezetimibe to statin therapy on cardiovascular outcomes and safety in patients with versus without diabetes mellitus: results from IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial). Circulation 2018;137:1571–1582. [DOI] [PubMed] [Google Scholar]

[bib44] 44. Lee SJ, Joo JH, Park S, Kim C, Choi DW, Lee YJ, Hong SJ, Ahn CM, Kim JS, Kim BK, Ko YG, Choi D, Jang Y, Nam CM, Hong MK. Combination therapy with moderate-intensity atorvastatin and ezetimibe versus high-intensity atorvastatin monotherapy in patients treated with percutaneous coronary intervention in practice: assessing RACING generalizability. Eur Heart J Cardiovasc Pharmacother 2023;10:676–685. [DOI] [PMC free article] [PubMed] [Google Scholar]

[bib45] 45. Kim B, Hong S, Lee Y, Hong SJ, Yun KH, Hong B, Heo JH, Rha S, Cho Y, Lee S, Ahn C, Kim J, Ko Y, Choi D, Jang Y, Hong M. Long-term efficacy and safety of moderate-intensity statin with ezetimibe combination therapy versus high-intensity statin monotherapy in patients with atherosclerotic cardiovascular disease (RACING): a randomised, open-label, non-inferiority trial. Lancet 2022;400:380–390. [DOI] [PubMed] [Google Scholar]

[bib46] 46. Schwartz GG, Steg PG, Szarek M, Bhatt DL, Bittner VA, Diaz R, Edelberg JM, Goodman SG, Hanotin C, Harrington RA, Jukema JW, Lecorps G, Mahaffey KW, Moryusef A, Pordy R, Quintero K, Roe MT, Sasiela WJ, Tamby J, Tricoci P, White HD, Zeiher AM. Alirocumab and cardiovascular outcomes after acute coronary syndrome. N Engl J Med 2018;379:2097–2107. [DOI] [PubMed] [Google Scholar]

[bib48] 48. Ganda OP, Plutzky J, Sanganalmath SK, Bujas‐Bobanovic M, Koren A, Mandel J, Letierce A, Leiter LA. Efficacy and safety of alirocumab among individuals with diabetes mellitus and atherosclerotic cardiovascular disease in the ODYSSEY phase 3 trials. Diabetes Obes Metab 2018;20:2389–2398. [DOI] [PMC free article] [PubMed] [Google Scholar]

[bib49] 49. Sabatine MS, Giugliano RP, Keech AC, Honarpour N, Wiviott SD, Murphy SA, Kuder JF, Wang H, Liu T, Wasserman SM, Sever PS, Pedersen TR. Evolocumab and clinical outcomes in patients with cardiovascular disease. N Engl J Med 2017;376:1713–1722. [DOI] [PubMed] [Google Scholar]

[bib50] 50. Sabatine MS, Leiter LA, Wiviott SD, Giugliano RP, Deedwania P, De Ferrari GM, Murphy SA, Kuder JF, Gouni-Berthold I, Lewis BS, Handelsman Y, Pineda AL, Honarpour N, Keech AC, Sever PS, Pedersen TR. Cardiovascular safety and efficacy of the PCSK9 inhibitor evolocumab in patients with and without diabetes and the effect of evolocumab on glycaemia and risk of new-onset diabetes: a prespecified analysis of the FOURIER randomised controlled trial. Lancet Diabetes Endocrinol 2017;5:941–950. [DOI] [PubMed] [Google Scholar]

[bib51] 51. Imbalzano E, Ilardi F, Orlando L, Pintaudi B, Savarese G, Rosano G. The efficacy of PCSK9 inhibitors on major cardiovascular events and lipid profile in patients with diabetes: a systematic review and meta-analysis of randomized controlled trials. Eur Heart J Cardiovasc Pharmacother 2023;9:318–327. [DOI] [PubMed] [Google Scholar]

[bib52] 52. Leiter LA, Cariou B, Müller‐Wieland D, Colhoun HM, Del Prato S, Tinahones FJ, Ray KK, Bujas‐Bobanovic M, Domenger C, Mandel J, Samuel R, Henry RR. Efficacy and safety of alirocumab in insulin-treated individuals with type 1 or type 2 diabetes and high cardiovascular risk: the ODYSSEY DM-INSULIN randomized trial. Diabetes Obes Metab 2017;19:1781–1792. [DOI] [PMC free article] [PubMed] [Google Scholar]

[bib53] 53. Mercep I, Strikic D, Hrabac P, Pecin I, Reiner Z. PCSK9 inhibition: from effectiveness to cost-effectiveness. Front Cardiovasc Med 2024;11:1339487. [DOI] [PMC free article] [PubMed] [Google Scholar]

[bib54] 54. Nissen SE, Lincoff AM, Brennan D, Ray KK, Mason D, Kastelein JJ, Thompson PD, Libby P, Cho L, Plutzky J, Bays HE, Moriarty PM, Menon V, Grobbee DE, Louie MJ, Chen C, Li N, Bloedon L, Robinson P, Horner M, Sasiela WJ, McCluskey J, Davey D, Fajardo-Campos P, Petrovic P, Fedacko J, Zmuda W, Lukyanov Y, Nicholls SJ. Bempedoic acid and cardiovascular outcomes in statin-intolerant patients. N Engl J Med 2023;388:1353–1364. [DOI] [PubMed] [Google Scholar]

[bib55] 55. Jo SH, Nam H, Lee J, Park S, Lee J, Kyoung DS. Fenofibrate use is associated with lower mortality and fewer cardiovascular events in patients with diabetes: results of 10,114 patients from the Korean National Health Insurance Service cohort. Diabetes Care 2021;44:1868–1876. [DOI] [PubMed] [Google Scholar]

[bib56] 56. Agewall S. New data on NOVEL ORAL ANTICOAGULANT, SGLT2i, lipid treatment and genetics. Eur Heart J Cardiovasc Pharmacother 2024;10:83–84. [DOI] [PubMed] [Google Scholar]

[bib57] 57. LENS Collaborative Group . Design, recruitment and baseline characteristics of the LENS trial. Diabet Med 2024;41:e15310. [DOI] [PMC free article] [PubMed] [Google Scholar]

[bib58] 58. Hostrup PE, Schmidt T, Hellsten SB, Gerwig RH, Størling J, Johannesen J, Sulek K, Hostrup M, Andersen HU, Buschard K, Hamid Y, Pociot F. Effect of fenofibrate on residual beta cell function in adults and adolescents with newly diagnosed type 1 diabetes: a randomised clinical trial. Diabetologia 2025;68:29–40. [DOI] [PMC free article] [PubMed] [Google Scholar]

[bib59] 59. O'Mahoney LL, Dunseath G, Churm R, Holmes M, Boesch C, Stavropoulos-Kalinoglou A, Ajjan RA, Birch KM, Orsi NM, Mappa G, Price OJ, Campbell MD. Omega-3 polyunsaturated fatty acid supplementation versus placebo on vascular health, glycaemic control, and metabolic parameters in people with type 1 diabetes: a randomised controlled preliminary trial. Cardiovasc Diabetol 2020;19:127. [DOI] [PMC free article] [PubMed] [Google Scholar]

[bib60] 60. Drexel H, Pocock SJ, Lewis BS, Saely CH, Kaski JC, Rosano GMC, Tautermann G, Huber K, Dopheide JF, Mader A, Niessner A, Savarese G, Schmidt TA, Semb AG, Tamargo J, Wassmann S, Clodi M, Kjeldsen KP, Agewall S. Subgroup analyses in randomized clinical trials: value and limitations. Review #3 on important aspects of randomized clinical trials in cardiovascular pharmacotherapy. Eur Heart J Cardiovasc Pharmacother 2022;8:302–310. [DOI] [PubMed] [Google Scholar]

[bib61] 61. Patti G, Spinoni EG, Grisafi L, Mehran R, Mennuni M. Safety and efficacy of very low LDL-cholesterol intensive lowering: a meta-analysis and meta-regression of randomized trials. Eur Heart J Cardiovasc Pharmacother 2023;9:138–147. [DOI] [PubMed] [Google Scholar]

PERMALINK

Management of dyslipidaemia in patients with comorbidities—facing the challenge: type 1 diabetes mellitus

Susanne Kaser

Dobromir Dobrev

Bianca Rocca

Juan Carlos Kaski

Stefan Agewall

Heinz Drexel

Abstract

Preface

Background

Epidemiology of cardiovascular disease in type 1 diabetes

Pathophysiology of cardiovascular disease in type 1 diabetes

LDL cholesterol

Hypertension

Hyperglycaemia and glycaemic fluctuation

Nonclassical risk factors and comorbidities

Current guidelines for lipid-lowering treatment in type 1 diabetes

Table 1.

Lipid-lowering agents

Statins

Ezetimibe

PCSK9 inhibitors

ATP citrate lyase inhibitor

Other lipid-lowering agents.

Summary and conclusion

Acknowledgements

Contributor Information

Data availability

References

Associated Data

Data Availability Statement

ACTIONS

PERMALINK

RESOURCES

Cite

Add to Collections

PERMALINK

Management of dyslipidaemia in patients with comorbidities—facing the challenge: type 1 diabetes mellitus

Susanne Kaser

Dobromir Dobrev

Bianca Rocca

Juan Carlos Kaski

Stefan Agewall

Heinz Drexel

Abstract

Preface

Background

Epidemiology of cardiovascular disease in type 1 diabetes

Pathophysiology of cardiovascular disease in type 1 diabetes

LDL cholesterol

Hypertension

Hyperglycaemia and glycaemic fluctuation

Nonclassical risk factors and comorbidities

Current guidelines for lipid-lowering treatment in type 1 diabetes

Table 1.

Lipid-lowering agents

Statins

Ezetimibe

PCSK9 inhibitors

ATP citrate lyase inhibitor

Other lipid-lowering agents.

Summary and conclusion

Acknowledgements

Contributor Information

Data availability

References

Associated Data

Data Availability Statement

ACTIONS

PERMALINK

RESOURCES

Similar articles

Cited by other articles

Links to NCBI Databases