Patients with type 1 diabetes (T1D) were less likely to experience cardiovascular events when compared to patients with type 2 diabetes (T2D), according to a recent study published in the Journal of the Society for Cardiovascular Angiography & Interventions.

Using data captured by the Veradigm Metabolic Registry from 2017 to 2022, Andrew Michael Goldsweig, MD, MS, FACC, et al., included 5,823 patients with T1D and 156,204 patients with T2D, with ages ranging from 46 to 75 years. They note that overall patients with T1D were younger and had fewer comorbidities. The authors compared the incidence rates of cardiovascular events among patients with T1D vs. patients with T2D. Cardiovascular events were defined as any of the following: myocardial infarction (MI), PCI, CABG, stroke, carotid revascularization, limb ischemia and peripheral revascularization.

Among the patients analyzed, 11,096 cardiovascular events occurred over the study period. Fewer events were associated with T1D vs. T2D, quantified by a prevalence ratio of 0.63 (95% CI, 0.55-0.71). Results were similar after adjusting for age (prevalence ratio, 0.66 [95% CI, 0.58-0.74]). When broken down by type of cardiovascular event, patients with T1D were associated with less MI, PCI, stroke and limb ischemia when compared to patients with T2D.

In addition, probability of cardiovascular event was lower for T1D than for T2D regardless of age, sex, before vs. during/after the COVID-19 pandemic, and after adjusting for comorbidities, hemoglobin A1c, and serum creatinine.

The authors highlight several study limitations, including the potential for incomplete or inaccurate registry data, the inability to apply causal inference methods to the dataset, the fact that T1D and T2D patient populations "are fundamentally different" when comparing age and comorbidities, and more.

"Although [T1D] may carry a lower risk of incident cardiovascular events than [T2D], the pathophysiology, prevention and treatment of cardiovascular disease in [T1D] remains poorly understood," write the authors. "Both clinical trials and retrospective studies in [T1D] patients are necessary to improve their care and reduce their risk of cardiovascular events."