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Article: Predictive value of high-sensitivity troponin-I for future adverse cardiovascular outcome in stable patients with type 2 diabetes mellitus

TitlePredictive value of high-sensitivity troponin-I for future adverse cardiovascular outcome in stable patients with type 2 diabetes mellitus
Authors
Issue Date2014
PublisherBioMed Central Ltd. The Journal's web site is located at http://www.cardiab.com/
Citation
Cardiovascular Diabetology, 2014, v. 13, article no. 63 How to Cite?
AbstractINTRODUCTION: High-sensitivity cardiac troponin I(hs-TnI) and T levels(hs-TnT) are sensitive biomarkers of cardiomyocyte turnover or necrosis. Prior studies of the predictive role of hs-TnT in type 2 diabetes mellitus(T2DM) patients have yielded conflicting results. This study aimed to determine whether hs-TnI, which is detectable in a higher proportion of normal subjects than hsTnT, is associated with a major adverse cardiovascular event(MACE) in T2DM patients. METHODS AND RESULTS: We compared hs-TnI level in stored serum samples from 276 consecutive patients (mean age 65 +/- 10 years; 57% male) with T2DM with that of 115 age-and sex-matched controls. All T2DM patients were prospectively followed up for at least 4 years for incidence of MACE including heart failure(HF), myocardial infarction(MI) and cardiovascular mortality. At baseline, 274(99%) patients with T2DM had detectable hs-TnI, and 57(21%) had elevated hs-TnI (male: 8.5 ng/L, female: 7.6 ng/L, above the 99th percentile in healthy controls). A total of 43 MACE occurred: HF(n = 18), MI(n = 11) and cardiovascular mortality(n = 14). Kaplan-Meier analysis showed that an elevated hs-TnI was associated with MACE, HF, MI and cardiovascular mortality. Although multivariate analysis revealed that an elevated hs-TnI independently predicted MACE, it had limited sensitivity(62.7%) and positive predictive value(38.5%). Contrary to this, a normal hs-TnI level had an excellent negative predictive value(92.2%) for future MACE in patients with T2DM. CONCLUSION: The present study demonstrates that elevated hs-TnI in patients with T2DM is associated with increased MACE, HF, MI and cardiovascular mortality. Importantly, a normal hs-TnI level has an excellent negative predictive value for future adverse cardiovascular events during long-term follow-up.
Persistent Identifierhttp://hdl.handle.net/10722/198040
ISSN
2015 Impact Factor: 4.534
2015 SCImago Journal Rankings: 1.757
PubMed Central ID

 

DC FieldValueLanguage
dc.contributor.authorYiu, KHen_US
dc.contributor.authorLau, GKKen_US
dc.contributor.authorZhao, CTen_US
dc.contributor.authorChan, YHen_US
dc.contributor.authorChen, Yen_US
dc.contributor.authorZhen, Zen_US
dc.contributor.authorWong, Aen_US
dc.contributor.authorLau, CPen_US
dc.contributor.authorTse, HFen_US
dc.date.accessioned2014-06-25T02:42:06Z-
dc.date.available2014-06-25T02:42:06Z-
dc.date.issued2014en_US
dc.identifier.citationCardiovascular Diabetology, 2014, v. 13, article no. 63en_US
dc.identifier.issn1475-2840en_US
dc.identifier.urihttp://hdl.handle.net/10722/198040-
dc.description.abstractINTRODUCTION: High-sensitivity cardiac troponin I(hs-TnI) and T levels(hs-TnT) are sensitive biomarkers of cardiomyocyte turnover or necrosis. Prior studies of the predictive role of hs-TnT in type 2 diabetes mellitus(T2DM) patients have yielded conflicting results. This study aimed to determine whether hs-TnI, which is detectable in a higher proportion of normal subjects than hsTnT, is associated with a major adverse cardiovascular event(MACE) in T2DM patients. METHODS AND RESULTS: We compared hs-TnI level in stored serum samples from 276 consecutive patients (mean age 65 +/- 10 years; 57% male) with T2DM with that of 115 age-and sex-matched controls. All T2DM patients were prospectively followed up for at least 4 years for incidence of MACE including heart failure(HF), myocardial infarction(MI) and cardiovascular mortality. At baseline, 274(99%) patients with T2DM had detectable hs-TnI, and 57(21%) had elevated hs-TnI (male: 8.5 ng/L, female: 7.6 ng/L, above the 99th percentile in healthy controls). A total of 43 MACE occurred: HF(n = 18), MI(n = 11) and cardiovascular mortality(n = 14). Kaplan-Meier analysis showed that an elevated hs-TnI was associated with MACE, HF, MI and cardiovascular mortality. Although multivariate analysis revealed that an elevated hs-TnI independently predicted MACE, it had limited sensitivity(62.7%) and positive predictive value(38.5%). Contrary to this, a normal hs-TnI level had an excellent negative predictive value(92.2%) for future MACE in patients with T2DM. CONCLUSION: The present study demonstrates that elevated hs-TnI in patients with T2DM is associated with increased MACE, HF, MI and cardiovascular mortality. Importantly, a normal hs-TnI level has an excellent negative predictive value for future adverse cardiovascular events during long-term follow-up.-
dc.languageengen_US
dc.publisherBioMed Central Ltd. The Journal's web site is located at http://www.cardiab.com/en_US
dc.relation.ispartofCardiovascular Diabetologyen_US
dc.rightsCreative Commons: Attribution 3.0 Hong Kong Licenseen_US
dc.subject.meshCardiovascular Diseases - blood - diagnosis - mortality-
dc.subject.meshDiabetes Mellitus, Type 2 - blood - diagnosis - mortality-
dc.subject.meshTroponin I - blood-
dc.titlePredictive value of high-sensitivity troponin-I for future adverse cardiovascular outcome in stable patients with type 2 diabetes mellitusen_US
dc.typeArticleen_US
dc.identifier.emailYiu, KH: khkyiu@hku.hken_US
dc.identifier.emailLau, GKK: gkklau@hku.hken_US
dc.identifier.emailZhao, CT: tingirl@hku.hken_US
dc.identifier.emailChan, YH: chanwill@hku.hken_US
dc.identifier.emailChen, Y: cheny818@hku.hken_US
dc.identifier.emailZhen, Z: zhenzhe@hku.hken_US
dc.identifier.emailLau, CP: cplau@hku.hken_US
dc.identifier.emailTse, HF: hftse@hkucc.hku.hken_US
dc.identifier.authorityYiu, KH=rp01490en_US
dc.identifier.authorityLau, GKK=rp01499en_US
dc.identifier.authorityChan, YH=rp01313en_US
dc.identifier.authorityTse, HF=rp00428en_US
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1186/1475-2840-13-63-
dc.identifier.pmid24661773-
dc.identifier.pmcidPMC4006634-
dc.identifier.hkuros229254en_US
dc.identifier.volume13en_US
dc.publisher.placeUnited Kingdomen_US

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