Troponin in diabetic patients with and without chronic coronary artery disease

BMC Cardiovascular Disorders

Roberto Kalil Filho¹  José Antonio Franchini Ramires¹  Raul Cavalcante Maranhão¹  Ana Luiza de Oliveira Carvalho¹  Alessandra Roggério¹  Marília da Costa Oliveira Sprandel¹  Celia Maria Cassaro Strunz¹  Desiderio Favarato¹  Paulo Cury Rezende¹  Rosa Maria Rahmi Garcia¹  Whady Hueb¹  Carlos Alexandre Wainrober Segre¹ 

[1] Department of Clinical Cardiology, Heart Institute (InCor) University of São Paulo, Av. Dr. Eneas de Carvalho Aguiar 44, AB, BL I, Sala 114, Cerqueira César, Sao Paulo 05403-000, SP, Brazil

关键词: Coronary artery disease;    Diabetes mellitus;    Troponin;    Biological markers;   

Others  :  1220600
DOI  :  10.1186/s12872-015-0051-z

 received in 2015-02-24, accepted in 2015-06-01,  发布年份 2015

【 摘 要 】

Background

Cardiac-specific troponin detected with the new high-sensitivity assays can be chronically elevated in response to cardiovascular comorbidities and confer important prognostic information, in the absence of unstable coronary syndromes. Both diabetes mellitus and coronary artery disease are known predictors of troponin elevation. It is not known whether diabetic patients with coronary artery disease have different levels of troponin compared with diabetic patients with normal coronary arteries. To investigate this question, we determined the concentrations of a level 1 troponin assay in two groups of diabetic patients: those with multivessel coronary artery disease and those with angiographically normal coronary arteries.

Methods

We studied 95 diabetic patients and compared troponin in serum samples from 50 patients with coronary artery disease (mean age = 63.7, 58 % male) with 45 controls with angiographically normal coronary arteries. Brain natriuretic peptide and the oxidative stress biomarkers myeloperoxidase, nitrotyrosine and oxidized LDL were also determined.

Results

Diabetic patients with coronary artery disease had higher levels of troponin than did controls (median values, 12.0 pg/mL (95 % CI:10–16) vs 7.0 pg/mL (95 % CI: 5.9-8.5), respectively; p = 0.0001). The area under the ROC curve for the diagnosis of CAD was 0.712 with a sensitivity of 70 % and a specificity of 66 %. Plasma BNP levels and oxidative stress variables (myeloperoxidase, nitrotyrosine, and oxidized LDL) were not different between the two groups. In a multivariate analysis, gender (p = 0.04), serum glucose (0.03) and Troponin I (p = 0.01) had independent statistical significance.

Conclusion

Troponin elevation is related to the presence of chronic coronary artery disease in diabetic patients with multiple associated cardiovascular risk factors. Troponin may serve as a biomarker in this high-risk population.

Trial registration

http://www.controlled-trials.com Registration number:ISRCTN26970041

【 授权许可】

   
2015 Segre et al.

【 图 表 】

Fig. 1.

Fig. 2.

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