Use of a new high-sensitivity assay for cardiac troponin T to stratify the risk of cardiovascular disease in outpatients with type-2 diabetes

Shogo Asano, Atsushi Suzuki, Junichi Ishii, Sahoko Sekiguchi-Ueda, Megumi Shibata, Yasumasa Yoshino, Kazuhiro Nakamura, Yasukazu Akiyama, Fumihiko Kitagawa, Toshiaki Sakuishi, Takashi Fujita, Mitsuyasu Itoh

Research output: Contribution to journalArticle

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Abstract

Background: Chronic elevation of cardiac troponin T (TnT) levels as measured by conventional assays is strongly associated with structural heart disease and cardiovascular events. A new high-sensitivity assay for TnT makes it possible to measure concentrations more than a factor of 5 lower than the limits of detection of conventional assays. We evaluated the utility of serum TnT as a risk marker of cardiovascular disease in 409 outpatients with type-2 diabetes mellitus (T2DM). Results: TnT was detectable (>0. 002 ng/mL) in 80% of patients, and elevation in TnT levels (>0. 014 ng/mL) was found in 19. 3%, suggesting a higher prevalence of structural heart diseases in T2DM patients. A history of cardiovascular disease was noted in 89 (22%) patients. Patients with diabetic microvascular complications and those with abnormal electrocardiogram including left ventricular hypertrophy had higher TnT levels. Patients with increased levels of TnT (>0. 014 ng/mL) were older, had higher values of N-terminal pro-B-type natriuretic peptide (NT-proBNP), C-reactive protein, cystatin C, and urinary albumin/creatinine ratio, had lower values of hemoglobin and estimated glomerular filtration rate, and had a higher prevalence of cardiovascular disease compared with those without increased TnT levels. In stepwise logistic analysis, NT-proBNP (odds ratio 7. 40 per 10-fold increase, P < 0. 0001) and cystatin C (18. 0 per 1. 0 mg/L, P < 0. 0001) were independently associated with elevation of TnT levels. HsTnT level, cystatin C, and HDL-cholesterol were also independent risk factors for history of major cardiovascular diseases in T2DM patients. Conclusion: This new high-sensitivity TnT assay may be useful for stratifying cardiovascular risk in outpatients with T2DM.

Original languageEnglish
Pages (from-to)29-36
Number of pages8
JournalDiabetology International
Volume3
Issue number1
DOIs
Publication statusPublished - 01-03-2012

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Troponin T
Type 2 Diabetes Mellitus
Outpatients
Cardiovascular Diseases
Cystatin C
Brain Natriuretic Peptide
Heart Diseases
Left Ventricular Hypertrophy
Diabetes Complications
Protein C
Glomerular Filtration Rate
C-Reactive Protein
HDL Cholesterol
Limit of Detection
Albumins
Creatinine
Electrocardiography
Hemoglobins
Odds Ratio

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Asano, Shogo ; Suzuki, Atsushi ; Ishii, Junichi ; Sekiguchi-Ueda, Sahoko ; Shibata, Megumi ; Yoshino, Yasumasa ; Nakamura, Kazuhiro ; Akiyama, Yasukazu ; Kitagawa, Fumihiko ; Sakuishi, Toshiaki ; Fujita, Takashi ; Itoh, Mitsuyasu. / Use of a new high-sensitivity assay for cardiac troponin T to stratify the risk of cardiovascular disease in outpatients with type-2 diabetes. In: Diabetology International. 2012 ; Vol. 3, No. 1. pp. 29-36.
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abstract = "Background: Chronic elevation of cardiac troponin T (TnT) levels as measured by conventional assays is strongly associated with structural heart disease and cardiovascular events. A new high-sensitivity assay for TnT makes it possible to measure concentrations more than a factor of 5 lower than the limits of detection of conventional assays. We evaluated the utility of serum TnT as a risk marker of cardiovascular disease in 409 outpatients with type-2 diabetes mellitus (T2DM). Results: TnT was detectable (>0. 002 ng/mL) in 80{\%} of patients, and elevation in TnT levels (>0. 014 ng/mL) was found in 19. 3{\%}, suggesting a higher prevalence of structural heart diseases in T2DM patients. A history of cardiovascular disease was noted in 89 (22{\%}) patients. Patients with diabetic microvascular complications and those with abnormal electrocardiogram including left ventricular hypertrophy had higher TnT levels. Patients with increased levels of TnT (>0. 014 ng/mL) were older, had higher values of N-terminal pro-B-type natriuretic peptide (NT-proBNP), C-reactive protein, cystatin C, and urinary albumin/creatinine ratio, had lower values of hemoglobin and estimated glomerular filtration rate, and had a higher prevalence of cardiovascular disease compared with those without increased TnT levels. In stepwise logistic analysis, NT-proBNP (odds ratio 7. 40 per 10-fold increase, P < 0. 0001) and cystatin C (18. 0 per 1. 0 mg/L, P < 0. 0001) were independently associated with elevation of TnT levels. HsTnT level, cystatin C, and HDL-cholesterol were also independent risk factors for history of major cardiovascular diseases in T2DM patients. Conclusion: This new high-sensitivity TnT assay may be useful for stratifying cardiovascular risk in outpatients with T2DM.",
author = "Shogo Asano and Atsushi Suzuki and Junichi Ishii and Sahoko Sekiguchi-Ueda and Megumi Shibata and Yasumasa Yoshino and Kazuhiro Nakamura and Yasukazu Akiyama and Fumihiko Kitagawa and Toshiaki Sakuishi and Takashi Fujita and Mitsuyasu Itoh",
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Asano, S, Suzuki, A, Ishii, J, Sekiguchi-Ueda, S, Shibata, M, Yoshino, Y, Nakamura, K, Akiyama, Y, Kitagawa, F, Sakuishi, T, Fujita, T & Itoh, M 2012, 'Use of a new high-sensitivity assay for cardiac troponin T to stratify the risk of cardiovascular disease in outpatients with type-2 diabetes', Diabetology International, vol. 3, no. 1, pp. 29-36. https://doi.org/10.1007/s13340-011-0057-4

Use of a new high-sensitivity assay for cardiac troponin T to stratify the risk of cardiovascular disease in outpatients with type-2 diabetes. / Asano, Shogo; Suzuki, Atsushi; Ishii, Junichi; Sekiguchi-Ueda, Sahoko; Shibata, Megumi; Yoshino, Yasumasa; Nakamura, Kazuhiro; Akiyama, Yasukazu; Kitagawa, Fumihiko; Sakuishi, Toshiaki; Fujita, Takashi; Itoh, Mitsuyasu.

In: Diabetology International, Vol. 3, No. 1, 01.03.2012, p. 29-36.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Use of a new high-sensitivity assay for cardiac troponin T to stratify the risk of cardiovascular disease in outpatients with type-2 diabetes

AU - Asano, Shogo

AU - Suzuki, Atsushi

AU - Ishii, Junichi

AU - Sekiguchi-Ueda, Sahoko

AU - Shibata, Megumi

AU - Yoshino, Yasumasa

AU - Nakamura, Kazuhiro

AU - Akiyama, Yasukazu

AU - Kitagawa, Fumihiko

AU - Sakuishi, Toshiaki

AU - Fujita, Takashi

AU - Itoh, Mitsuyasu

PY - 2012/3/1

Y1 - 2012/3/1

N2 - Background: Chronic elevation of cardiac troponin T (TnT) levels as measured by conventional assays is strongly associated with structural heart disease and cardiovascular events. A new high-sensitivity assay for TnT makes it possible to measure concentrations more than a factor of 5 lower than the limits of detection of conventional assays. We evaluated the utility of serum TnT as a risk marker of cardiovascular disease in 409 outpatients with type-2 diabetes mellitus (T2DM). Results: TnT was detectable (>0. 002 ng/mL) in 80% of patients, and elevation in TnT levels (>0. 014 ng/mL) was found in 19. 3%, suggesting a higher prevalence of structural heart diseases in T2DM patients. A history of cardiovascular disease was noted in 89 (22%) patients. Patients with diabetic microvascular complications and those with abnormal electrocardiogram including left ventricular hypertrophy had higher TnT levels. Patients with increased levels of TnT (>0. 014 ng/mL) were older, had higher values of N-terminal pro-B-type natriuretic peptide (NT-proBNP), C-reactive protein, cystatin C, and urinary albumin/creatinine ratio, had lower values of hemoglobin and estimated glomerular filtration rate, and had a higher prevalence of cardiovascular disease compared with those without increased TnT levels. In stepwise logistic analysis, NT-proBNP (odds ratio 7. 40 per 10-fold increase, P < 0. 0001) and cystatin C (18. 0 per 1. 0 mg/L, P < 0. 0001) were independently associated with elevation of TnT levels. HsTnT level, cystatin C, and HDL-cholesterol were also independent risk factors for history of major cardiovascular diseases in T2DM patients. Conclusion: This new high-sensitivity TnT assay may be useful for stratifying cardiovascular risk in outpatients with T2DM.

AB - Background: Chronic elevation of cardiac troponin T (TnT) levels as measured by conventional assays is strongly associated with structural heart disease and cardiovascular events. A new high-sensitivity assay for TnT makes it possible to measure concentrations more than a factor of 5 lower than the limits of detection of conventional assays. We evaluated the utility of serum TnT as a risk marker of cardiovascular disease in 409 outpatients with type-2 diabetes mellitus (T2DM). Results: TnT was detectable (>0. 002 ng/mL) in 80% of patients, and elevation in TnT levels (>0. 014 ng/mL) was found in 19. 3%, suggesting a higher prevalence of structural heart diseases in T2DM patients. A history of cardiovascular disease was noted in 89 (22%) patients. Patients with diabetic microvascular complications and those with abnormal electrocardiogram including left ventricular hypertrophy had higher TnT levels. Patients with increased levels of TnT (>0. 014 ng/mL) were older, had higher values of N-terminal pro-B-type natriuretic peptide (NT-proBNP), C-reactive protein, cystatin C, and urinary albumin/creatinine ratio, had lower values of hemoglobin and estimated glomerular filtration rate, and had a higher prevalence of cardiovascular disease compared with those without increased TnT levels. In stepwise logistic analysis, NT-proBNP (odds ratio 7. 40 per 10-fold increase, P < 0. 0001) and cystatin C (18. 0 per 1. 0 mg/L, P < 0. 0001) were independently associated with elevation of TnT levels. HsTnT level, cystatin C, and HDL-cholesterol were also independent risk factors for history of major cardiovascular diseases in T2DM patients. Conclusion: This new high-sensitivity TnT assay may be useful for stratifying cardiovascular risk in outpatients with T2DM.

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