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Comparative Study
. 2011 Jun 21;123(24):2811-8.
doi: 10.1161/CIRCULATIONAHA.110.009928. Epub 2011 May 31.

Sensitive cardiac troponin T assay and the risk of incident cardiovascular disease in women with and without diabetes mellitus: the Women's Health Study

Brendan M Everett  1 , Nancy R Cook, Maria C Magnone, Maria Bobadilla, Eunjung Kim, Nader Rifai, Paul M Ridker, Aruna D Pradhan
Affiliations
Comparative Study

Sensitive cardiac troponin T assay and the risk of incident cardiovascular disease in women with and without diabetes mellitus: the Women's Health Study

Brendan M Everett et al. Circulation. .

Abstract

Background: Very low levels of cardiac troponin T are associated with an increased risk of cardiovascular death in patients with stable chronic coronary disease. Whether high-sensitivity cardiac troponin T levels are associated with adverse cardiovascular outcomes in individuals without cardiovascular disease (CVD) has not been well studied.

Methods and results: Using 2 complementary study designs, we evaluated the relationship between baseline cardiac troponin and incident CVD events among diabetic and nondiabetic participants in the Women's Health Study (median follow-up, 12.3 years). All diabetic women with blood specimens were included in a cohort study (n=512 diabetic women, n=65 events), and nondiabetic women were sampled for inclusion in a case-cohort analysis (n=564 comprising the subcohort, n=479 events). High-sensitivity cardiac troponin T was detectable (≥ 0.003 μg/L) in 45.5% of diabetic women and 30.3% of nondiabetic women (P<0.0001). In models adjusted for traditional risk factors and hemoglobin A(1c), detectable high-sensitivity cardiac troponin T was associated with subsequent CVD (myocardial infarction, stroke, cardiovascular death) in diabetic women (adjusted hazard ratio, 1.79; 95% confidence interval, 1.04 to 3.07, P=0.036) but not nondiabetic women (adjusted hazard ratio, 1.13; 95% confidence interval, 0.82 to 1.55; P=0.46). Further adjustment for amino-terminal pro-B-type natriuretic peptide and estimated renal function did not substantially alter this relationship among diabetic women (hazard ratio, 1.76; 95% confidence interval, 1.00 to 3.08; P=0.0499), which appeared to be driven by a 3-fold increase in CVD death that was not observed in nondiabetic women.

Conclusions: Very low but detectable levels of cardiac troponin T are associated with total CVD and CVD death in women with diabetes mellitus. Among healthy nondiabetic women, detectable compared with undetectable troponin was not associated with CVD events.

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Conflict of interest statement

Conflict of Interest Disclosures Drs. Everett and Ridker are the recipients of investigator-initiated research awards from Roche Diagnostics. Drs. Magnone and Bobadilla are employees of Hoffmann-La Roche Ltd.

Figures

Figure
Figure
Distribution of detectable hsTnT levels (≥ 0.003 μg/L) in diabetic women and in the reference subcohort of non-diabetic women.
See this image and copyright information in PMC

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