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. 2010 Sep 15:9:52.
doi: 10.1186/1475-2840-9-52.

Determinants and prognostic implications of cardiac troponin T measured by a sensitive assay in type 2 diabetes mellitus

Jonas Hallén  1 , Odd Erik Johansen, Kåre I Birkeland, Lars Gullestad, Svend Aakhus, Knut Endresen, Solve Tjora, Allan S Jaffe, Dan Atar
Affiliations

Determinants and prognostic implications of cardiac troponin T measured by a sensitive assay in type 2 diabetes mellitus

Jonas Hallén et al. Cardiovasc Diabetol. .

Abstract

Background: The cardiac troponins are biomarkers used for diagnosis of myocardial injury. They are also powerful prognostic markers in many diseases and settings. Recently introduced high-sensitivity assays indicate that chronic cardiac troponin elevations are common in response to cardiovascular (CV) morbidity. Type 2 diabetes mellitus (T2DM) confers a high risk of CV disease, but little is known about chronic cardiac troponin elevations in diabetic subjects. Accordingly, we aimed to understand the prevalence, determinants, and prognostic implications of cardiac troponin T (cTnT) elevations measured with a high-sensitivity assay in patients with T2DM.

Methods: cTnT was measured in stored, frozen serum samples from 124 subjects enrolled in the Asker and Bærum Cardiovascular Diabetes trial at baseline and at 2-year follow-up, if available (96 samples available). Results were analyzed in relation to baseline variables, hospitalizations, and group assignment (multifactorial intensive versus conventional diabetes care for lowering CV risk).

Results: One-hundred thirteen (90%) had detectable cTnT at baseline and of those, 22 (18% of the total population) subjects had values above the 99th percentile for healthy controls (13.5 ng/L). Levels at baseline were associated with conventional CV risk factors (age, renal function, gender). There was a strong correlation between cTnT levels at the two time-points (r=0.92, p>0.001). Risk for hospitalizations during follow-up increased step-wise by quartiles of hscTnT measured at baseline (p=0.058).

Conclusions: Elevations of cTnT above the 99th percentile measured by a highly sensitive assay were encountered frequently in a population of T2DM patients. cTnT levels appeared to be stable over time and associated with conventional CV risk factors. Although a clear trend was present, no statistically robust associations with adverse outcomes could be found.

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Figures

Figure 1
Figure 1
Flow chart showing number of patients included for cross-sectional and prospective investigation and reasons for exclusion; and the number of patients who had troponin T measured at the two time points.
Figure 2
Figure 2
Distribution of cardiac troponin T by the high-sensitivity assay in patients with type 2 diabetes mellitus.
Figure 3
Figure 3
Scatter plot of cardiac troponin T values at baseline and 2 years.
Figure 4
Figure 4
Bar charts of all-cause and diabetes-related hospitalizations according to cardiac troponin T levels stratified by quartiles at baseline. P-value for trend is 0.058 (all-cause) and .055 (diabetes-related). CV = cardiovascular
See this image and copyright information in PMC

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