Abstract 10916: Utility of Serum Concentration of High-Sensitivity Cardiac Troponin T as a Screening Marker of Cardiovascular Risk in Outpatients with Type-2 Diabetes
Background: Recently, circulating high-sensitivity troponin T (hsTnT) level has been reported to be associated with structural heart diseases and subsequent risk for all-cause mortality in the general population. Thus, we investigated prospectively the utility of hsTnT as a marker to stratify cardiovascular risk in outpatients with type-2 diabetes mellitus (T2DM).
Methods: We measured serum levels of hsTnT, N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hsCRP) and cystatin C and urinary albumin/creatinine ratio in 409 consecutive outpatients with T2DM (median age, 66 yrs; 241 males). A previous history of cardiovascular disease, which was defined as acute coronary syndrome, heart failure or stroke, was present in 89 (22%) patients. Cardiovascular event was defined as cardiovascular death or hospitalization for cardiovascular disease.
Results: Serum hsTnT was detected (> lower detection limit of 2 pg/mL) in 80% of patients, and was higher than 14 pg/mL (99th percentile in apparently healthy subjects) in 19.3%. Patients with increased hsTnT (> 14 pg/mL) were older, had higher values of NT-proBNP, hsCRP, cystatin C, and urinary albumin/creatinine ratio, had a lower value of estimated glomerular filtration rate (GFR), and had a higher prevalence of cardiovascular disease compared with those without it (Table). During mean follow-up period of 11 months, there were 189 (4.4%) cardiovascular events, including 2 cardiovascular deaths. On a stepwise Cox regression analysis including 8 clinical and biochemical variables, increased hsTnT (relative risk 4.08, P = 0.004) and a history of cardiovascular disease (3.62, P = 0.01) were independently associated with cardiovascular events. In the Kaplan-Meier analysis, patients with increased hsTnT had a higher risk of cardiac events than those without it (P < 0.0001).
Conclusion: An hsTnT may be useful as a screening marker of cardiovascular risk in this population.
- © 2011 by American Heart Association, Inc.