DIABETES, OTHER DISEASES, AND NEW COMPLICATIONS: EMERGING ASSOCIATIONS (JJ NOLAN, SECTION EDITOR) Cardiac Autoimmunity as a Novel Biomarker, Mediator, and Therapeutic Target of Heart Disease in Type 1 Diabetes

# The Author(s) 2015. This article is published with open access at Springerlink.com Abstract Patients with type 1 diabetes (T1D) suffer excess mortality from cardiovascular disease (CVD) that has persisted despite substantial reductions in microvascular com-plications. Although T1D and type 2 diabetes (T2D) are etio-logically distinct, it has generally been assumed that CVD in T1D is Bthe same disease ^ as that found in T2D. Here, we review the most recent epidemiological and clinical studies on heart disease in T1D, highlighting differences between CVD in T1D and T2D. In addition, we discuss experimental and clinical evidence for a post-myocardial infarction (MI) autoimmune heart syndrome in T1D, including the develop-ment of diagnostic assays which we believe can, for the first time, differentiate between heart disease in T1D and T2D. We postulate that a clinically unrecognized form of chronic myo-cardial inflammation (Bmyocarditis^) triggered byMI contrib-utes to the poor CVD outcomes in T1D. These findings pro-vide a conceptual shift in our understanding of CVD in T1D and have important diagnostic and therapeutic implications