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Conference Paper: Predictive value of high-sensitivity troponin-l for adverse cardiovascular outcomes in patients with type 2 diabetes mellitus
Title | Predictive value of high-sensitivity troponin-l for adverse cardiovascular outcomes in patients with type 2 diabetes mellitus |
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Authors | |
Issue Date | 2013 |
Publisher | Oxford University Press. The Journal's web site is located at http://eurheartj.oxfordjournals.org/ |
Citation | European Society of Cardiology (ESC) Congress 2013, Amsterdam, The Netherlands, 31 August - 4 September 2013. In European Heart Journal, 2013, v. 34 n. Suppl. 1, p. 787, abstract no. P4263 How to Cite? |
Abstract | Background: High-sensitivity cardiac troponins I (hs-TnI) and T levels (hs-TnT) are sensitive biomarkers of cardiomyocytes turnover or necrosis. Prior studies on the predictive role of hs-TnT in type 2 diabetes mellitus (T2DM) patients had yielded conflicting results. This study aimed to determine whether hs-TnI, which is detectable in a higher proportion of normal subjects than hsTnT are associated with adverse cardiovascular events in T2DM patients.
Methods: We measured hs-TnI level in 276 consecutive patients (mean age 65±10 years; 57% male) with T2DM compared with 115 age-and sex-matched controls. All T2DM patients were prospectively followed up for at least 4 years for incident of major adverse cardiovascular events (MACE) including heart failure (HF), myocardial infarction (MI) and cardiovascular mortality.
Results: At baseline, 274 (99%) patients had detectable hs-TnI, and 57 (21%) of them had elevated hs-TnI (male: 8.5 ng/L, female: 7.6ng/L, above the 99th percentile in healthy controls). A total of 43 MACE included HF (n=18), MI (n=11) and cardiovascular mortality (n=14) occurred. Kaplan-Meier analysis showed that an elevated hs-TnI was associated with MACE (Figure), HF, and cardiovascular
mortality but not MI. Although multivariate analysis revealed elevated hs-TnI independently predicts MACE, it had limited sensitivity (62.7%) and positive predictive value (38.5%) for MACE. Conversely, a normal hs-TnI level had an excellent negative predictive value (92.2%) for adverse cardiovascular events.
Conclusion: Our results demonstrated that elevated hs-TnI in T2DM patients is
associated with increased MACE, HF and cardiovascular mortality. Importantly, a normal hs-TnI level has an excellent negative predictive value for adverse cardiovascular events in T2DM patients during long-term follow-up. |
Description | Invited Speaker - SPOTLIGHT 2013 - abstract no. P4263 |
Persistent Identifier | http://hdl.handle.net/10722/270784 |
ISSN | 2023 Impact Factor: 37.6 2023 SCImago Journal Rankings: 4.091 |
DC Field | Value | Language |
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dc.contributor.author | Yiu, KH | - |
dc.contributor.author | Zhao, CT | - |
dc.contributor.author | Liu, S | - |
dc.contributor.author | Siu, CW | - |
dc.contributor.author | Tse, HF | - |
dc.date.accessioned | 2019-06-10T09:02:29Z | - |
dc.date.available | 2019-06-10T09:02:29Z | - |
dc.date.issued | 2013 | - |
dc.identifier.citation | European Society of Cardiology (ESC) Congress 2013, Amsterdam, The Netherlands, 31 August - 4 September 2013. In European Heart Journal, 2013, v. 34 n. Suppl. 1, p. 787, abstract no. P4263 | - |
dc.identifier.issn | 0195-668X | - |
dc.identifier.uri | http://hdl.handle.net/10722/270784 | - |
dc.description | Invited Speaker - SPOTLIGHT 2013 - abstract no. P4263 | - |
dc.description.abstract | Background: High-sensitivity cardiac troponins I (hs-TnI) and T levels (hs-TnT) are sensitive biomarkers of cardiomyocytes turnover or necrosis. Prior studies on the predictive role of hs-TnT in type 2 diabetes mellitus (T2DM) patients had yielded conflicting results. This study aimed to determine whether hs-TnI, which is detectable in a higher proportion of normal subjects than hsTnT are associated with adverse cardiovascular events in T2DM patients. Methods: We measured hs-TnI level in 276 consecutive patients (mean age 65±10 years; 57% male) with T2DM compared with 115 age-and sex-matched controls. All T2DM patients were prospectively followed up for at least 4 years for incident of major adverse cardiovascular events (MACE) including heart failure (HF), myocardial infarction (MI) and cardiovascular mortality. Results: At baseline, 274 (99%) patients had detectable hs-TnI, and 57 (21%) of them had elevated hs-TnI (male: 8.5 ng/L, female: 7.6ng/L, above the 99th percentile in healthy controls). A total of 43 MACE included HF (n=18), MI (n=11) and cardiovascular mortality (n=14) occurred. Kaplan-Meier analysis showed that an elevated hs-TnI was associated with MACE (Figure), HF, and cardiovascular mortality but not MI. Although multivariate analysis revealed elevated hs-TnI independently predicts MACE, it had limited sensitivity (62.7%) and positive predictive value (38.5%) for MACE. Conversely, a normal hs-TnI level had an excellent negative predictive value (92.2%) for adverse cardiovascular events. Conclusion: Our results demonstrated that elevated hs-TnI in T2DM patients is associated with increased MACE, HF and cardiovascular mortality. Importantly, a normal hs-TnI level has an excellent negative predictive value for adverse cardiovascular events in T2DM patients during long-term follow-up. | - |
dc.language | eng | - |
dc.publisher | Oxford University Press. The Journal's web site is located at http://eurheartj.oxfordjournals.org/ | - |
dc.relation.ispartof | European Heart Journal | - |
dc.relation.ispartof | European Society of Cardiology (ESC) Congress 2013 | - |
dc.title | Predictive value of high-sensitivity troponin-l for adverse cardiovascular outcomes in patients with type 2 diabetes mellitus | - |
dc.type | Conference_Paper | - |
dc.identifier.email | Yiu, KH: khkyiu@hku.hk | - |
dc.identifier.email | Zhao, CT: tingirl@hku.hk | - |
dc.identifier.email | Siu, CW: cwdsiu@hkucc.hku.hk | - |
dc.identifier.email | Tse, HF: hftse@hkucc.hku.hk | - |
dc.identifier.authority | Yiu, KH=rp01490 | - |
dc.identifier.authority | Siu, CW=rp00534 | - |
dc.identifier.authority | Tse, HF=rp00428 | - |
dc.identifier.doi | 10.1093/eurheartj/eht309.P4263 | - |
dc.identifier.hkuros | 224180 | - |
dc.identifier.volume | 34 | - |
dc.identifier.issue | Suppl. 1 | - |
dc.identifier.spage | 787 | - |
dc.identifier.epage | 787 | - |
dc.publisher.place | United Kingdom | - |
dc.identifier.issnl | 0195-668X | - |