Predictive value of high-sensitivity troponin-I for future adverse cardiovascular outcome in stable patients with type 2 diabetes mellitusReportar como inadecuado




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Cardiovascular Diabetology

, 13:63

First Online: 25 March 2014Received: 15 January 2014Accepted: 08 March 2014

Abstract

IntroductionHigh-sensitivity cardiac troponin Ihs-TnI and T levelshs-TnT are sensitive biomarkers of cardiomyocyte turnover or necrosis. Prior studies of the predictive role of hs-TnT in type 2 diabetes mellitusT2DM 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 eventMACE in T2DM patients.

Methods and resultsWe 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 failureHF, myocardial infarctionMI and cardiovascular mortality. At baseline, 27499% patients with T2DM had detectable hs-TnI, and 5721% had elevated hs-TnI male: 8.5 ng-L, female: 7.6 ng-L, above the 99 percentile in healthy controls. A total of 43 MACE occurred: HFn = 18, MIn = 11 and cardiovascular mortalityn = 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 sensitivity62.7% and positive predictive value38.5%. Contrary to this, a normal hs-TnI level had an excellent negative predictive value92.2% for future MACE in patients with T2DM.

ConclusionThe 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.

KeywordsType 2 diabetes mellitus High-sensitivity troponin I outcome Electronic supplementary materialThe online version of this article doi:10.1186-1475-2840-13-63 contains supplementary material, which is available to authorized users.

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Autor: Kai-Hang Yiu - Kui-Kai Lau - Chun-Ting Zhao - Yap-Hang Chan - Yan Chen - Zhe Zhen - Arthur Wong - Chu-Pak Lau - Hung-Fat 

Fuente: https://link.springer.com/article/10.1186/1475-2840-13-63



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