TY - JOUR
T1 - Determinants and prognostic implications of cardiac troponin T measured by a sensitive assay in type 2 diabetes mellitus.
AU - Hallén, Jonas
AU - Johansen, Odd Erik
AU - Birkeland, Kåre I.
AU - Gullestad, Lars
AU - Aakhus, Svend
AU - Endresen, Knut
AU - Tjora, Solve
AU - Jaffe, Allan S.
AU - Atar, Dan
N1 - Funding Information:
Roche Diagnostics (Basel, Switzerland) provided reagents for troponin T assays. JH and OEJ were supported by grants from the South-Eastern Norway Regional Health Authority. JH also received support from Aker University Hospital Research Foundation and Center for Heart Failure Research, Oslo, Norway. ASJ has consulted over time for most of the major diagnostic companies. OEJ is an associated post-doctoral researcher at Vestre Viken, Asker and Bærum Hospital (Rud, Norway) and JH is a PhD student at Oslo University Hospital and the University of Oslo, but both are employees of Boehringer Ingelheim.
PY - 2010
Y1 - 2010
N2 - The cardiac troponins are biomarkers used for diagnosis of myocardial injury. They are also powerful prognostic markers in many diseases and settings. Recently introduced high-sensitivity assays indicate that chronic cardiac troponin elevations are common in response to cardiovascular (CV) morbidity. Type 2 diabetes mellitus (T2DM) confers a high risk of CV disease, but little is known about chronic cardiac troponin elevations in diabetic subjects. Accordingly, we aimed to understand the prevalence, determinants, and prognostic implications of cardiac troponin T (cTnT) elevations measured with a high-sensitivity assay in patients with T2DM. cTnT was measured in stored, frozen serum samples from 124 subjects enrolled in the Asker and Bærum Cardiovascular Diabetes trial at baseline and at 2-year follow-up, if available (96 samples available). Results were analyzed in relation to baseline variables, hospitalizations, and group assignment (multifactorial intensive versus conventional diabetes care for lowering CV risk). One-hundred thirteen (90%) had detectable cTnT at baseline and of those, 22 (18% of the total population) subjects had values above the 99th percentile for healthy controls (13.5 ng/L). Levels at baseline were associated with conventional CV risk factors (age, renal function, gender). There was a strong correlation between cTnT levels at the two time-points (r=0.92, p>0.001). Risk for hospitalizations during follow-up increased step-wise by quartiles of hscTnT measured at baseline (p=0.058). Elevations of cTnT above the 99th percentile measured by a highly sensitive assay were encountered frequently in a population of T2DM patients. cTnT levels appeared to be stable over time and associated with conventional CV risk factors. Although a clear trend was present, no statistically robust associations with adverse outcomes could be found.
AB - The cardiac troponins are biomarkers used for diagnosis of myocardial injury. They are also powerful prognostic markers in many diseases and settings. Recently introduced high-sensitivity assays indicate that chronic cardiac troponin elevations are common in response to cardiovascular (CV) morbidity. Type 2 diabetes mellitus (T2DM) confers a high risk of CV disease, but little is known about chronic cardiac troponin elevations in diabetic subjects. Accordingly, we aimed to understand the prevalence, determinants, and prognostic implications of cardiac troponin T (cTnT) elevations measured with a high-sensitivity assay in patients with T2DM. cTnT was measured in stored, frozen serum samples from 124 subjects enrolled in the Asker and Bærum Cardiovascular Diabetes trial at baseline and at 2-year follow-up, if available (96 samples available). Results were analyzed in relation to baseline variables, hospitalizations, and group assignment (multifactorial intensive versus conventional diabetes care for lowering CV risk). One-hundred thirteen (90%) had detectable cTnT at baseline and of those, 22 (18% of the total population) subjects had values above the 99th percentile for healthy controls (13.5 ng/L). Levels at baseline were associated with conventional CV risk factors (age, renal function, gender). There was a strong correlation between cTnT levels at the two time-points (r=0.92, p>0.001). Risk for hospitalizations during follow-up increased step-wise by quartiles of hscTnT measured at baseline (p=0.058). Elevations of cTnT above the 99th percentile measured by a highly sensitive assay were encountered frequently in a population of T2DM patients. cTnT levels appeared to be stable over time and associated with conventional CV risk factors. Although a clear trend was present, no statistically robust associations with adverse outcomes could be found.
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U2 - 10.1186/1475-2840-9-52
DO - 10.1186/1475-2840-9-52
M3 - Article
C2 - 20843304
AN - SCOPUS:77956514329
SN - 1475-2840
VL - 9
SP - 52
JO - Cardiovascular diabetology
JF - Cardiovascular diabetology
ER -