Detectable cardiac troponin T linked to CVD in women with diabetes
MedWire News: Detectable levels of cardiac troponin T are predictive of cardiovascular disease (CVD) and death in diabetic, but not nondiabetic women, show study results.
"Cardiac troponin is the preferred marker of myocardial necrosis in patients with acute coronary syndromes, and a strong predictor of adverse outcome in patients with chronic heart failure or coronary heart disease," explain Brendan Everett (Brigham and Women's Hospital, Boston, Massachusetts, USA) and colleagues.
"However, troponin is rarely detectable in healthy patients when conventional assays are used. Whether very low levels of troponin detected by a novel high-sensitivity assay are associated with adverse outcomes in otherwise healthy diabetic and nondiabetic women has not been well studied," they add.
To investigate, Everett and co-workers assessed the relationship between levels of cardiac troponin T on enrollment, and incident CVD events (myocardial infarction, stroke, cardiovascular death) in diabetic and nondiabetic participants of the Women's Health Study aged 56 years, on average, at baseline. The median follow-up was 12.3 years.
In total, 512 diabetic and 564 nondiabetic women had blood samples taken at enrollment. The researchers detected cardiac troponin T levels of 0.003 µg/l or above in 45.5% of the diabetic and 30.3% of the nondiabetic women.
When the research team adjusted results for traditional risk factors, glycated hemoglobin, amino-terminal pro-B-type natriuretic peptide, and estimated renal function, detectable cardiac troponin T was associated with a significant 79% increase in CVD event risk in diabetic women.
Nondiabetic women with detectable cardiac troponin T levels did have a slight 13% increase in risk for CVD events, but this was not statistically significant.
Everett et al write that the significant association between detectable cardiac troponin T and CVD events in women with diabetes appeared to be largely driven by a three-fold increase in CVD-related deaths during follow-up that was not observed nondiabetic patients.
"These data raise the possibility that high sensitivity troponin could serve as a complimentary marker of cardiovascular risk and a means of further risk stratification in women with diabetes mellitus," conclude the authors in the journal Circulation.
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By Helen Albert