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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
Title | Predictive value of high-sensitivity troponin-I for future adverse cardiovascular outcome in stable patients with type 2 diabetes mellitus |
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Authors | |
Keywords | High-sensitivity troponin I outcome Type 2 diabetes mellitus |
Issue Date | 2014 |
Publisher | BioMed 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? |
Abstract | INTRODUCTION: 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 Identifier | http://hdl.handle.net/10722/198040 |
ISSN | 2023 Impact Factor: 8.5 2023 SCImago Journal Rankings: 2.621 |
PubMed Central ID | |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Yiu, KH | en_US |
dc.contributor.author | Lau, GKK | en_US |
dc.contributor.author | Zhao, CT | en_US |
dc.contributor.author | Chan, YH | en_US |
dc.contributor.author | Chen, Y | en_US |
dc.contributor.author | Zhen, Z | en_US |
dc.contributor.author | Wong, A | en_US |
dc.contributor.author | Lau, CP | en_US |
dc.contributor.author | Tse, HF | en_US |
dc.date.accessioned | 2014-06-25T02:42:06Z | - |
dc.date.available | 2014-06-25T02:42:06Z | - |
dc.date.issued | 2014 | en_US |
dc.identifier.citation | Cardiovascular Diabetology, 2014, v. 13, article no. 63 | en_US |
dc.identifier.issn | 1475-2840 | en_US |
dc.identifier.uri | http://hdl.handle.net/10722/198040 | - |
dc.description.abstract | INTRODUCTION: 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.language | eng | en_US |
dc.publisher | BioMed Central Ltd. The Journal's web site is located at http://www.cardiab.com/ | en_US |
dc.relation.ispartof | Cardiovascular Diabetology | en_US |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | en_US |
dc.subject | High-sensitivity troponin I outcome | - |
dc.subject | Type 2 diabetes mellitus | - |
dc.subject.mesh | Cardiovascular Diseases - blood - diagnosis - mortality | - |
dc.subject.mesh | Diabetes Mellitus, Type 2 - blood - diagnosis - mortality | - |
dc.subject.mesh | Troponin I - blood | - |
dc.title | Predictive value of high-sensitivity troponin-I for future adverse cardiovascular outcome in stable patients with type 2 diabetes mellitus | en_US |
dc.type | Article | en_US |
dc.identifier.email | Yiu, KH: khkyiu@hku.hk | en_US |
dc.identifier.email | Lau, GKK: gkklau@hku.hk | en_US |
dc.identifier.email | Zhao, CT: tingirl@hku.hk | en_US |
dc.identifier.email | Chan, YH: chanwill@hku.hk | en_US |
dc.identifier.email | Chen, Y: cheny818@hku.hk | en_US |
dc.identifier.email | Zhen, Z: zhenzhe@hku.hk | en_US |
dc.identifier.email | Lau, CP: cplau@hku.hk | en_US |
dc.identifier.email | Tse, HF: hftse@hkucc.hku.hk | en_US |
dc.identifier.authority | Yiu, KH=rp01490 | en_US |
dc.identifier.authority | Lau, GKK=rp01499 | en_US |
dc.identifier.authority | Chan, YH=rp01313 | en_US |
dc.identifier.authority | Tse, HF=rp00428 | en_US |
dc.description.nature | published_or_final_version | - |
dc.identifier.doi | 10.1186/1475-2840-13-63 | - |
dc.identifier.pmid | 24661773 | - |
dc.identifier.pmcid | PMC4006634 | - |
dc.identifier.scopus | eid_2-s2.0-84899635434 | - |
dc.identifier.hkuros | 229254 | en_US |
dc.identifier.volume | 13 | en_US |
dc.identifier.isi | WOS:000335191200001 | - |
dc.publisher.place | United Kingdom | en_US |
dc.identifier.issnl | 1475-2840 | - |