Distribution and prognostic value of high-sensitivity cardiac troponin T and I across glycemic status: a population-based study
Authors' conclusion
Hs-cTnT and hs-cTnI demonstrated consistent prognostic associations across glycemic status but incremental predictive values in hyperglycemic populations only. The susceptibility of hs-cTnT 99th percentiles to diabetes plus the additive value of hs-cTnI to hs-cTnT in diabetic cardiovascular risk stratification suggested hs-cTnI and hs-cTnT may be differentially associated with glycemic status, but further research is needed to illustrate the interaction between hyperglycemia and hs-cTn.
Study context
- Population
- Adults from NHANES 1999–2004 with determined glycemic status and at least one high-sensitivity cardiac troponin (hs-cTn) assay measured9,714 in prognostic analyses
- Participants
- 10,127 adults
- Exposure
- hs-cTnT and hs-cTnI across normoglycemic, prediabetic and diabetic populations
- Normoglycemicn = 5,946reference
- Prediabeticn = 2,172
- Diabeticn = 1,596
- Outcome
- Associations of hs-cTn with all-cause and cardiac-specific mortality
- Follow-up
- Median 16.8 years
Methodological detailsNHANES 1999-2004, complex survey design
- NHANES 1999-2004
- Complex survey design
Main finding
As reported in the abstract
hs-cTnT, aHR
1.77
95% CI 1.48–2.12P < .001
hs-cTnI (Abbott), aHR
1.83
95% CI 1.33–2.53P < .001
Observational data: associations, not effects.
Further findings
Incremental value to risk score for cardiac-specific mortality (10-year AUC), diabetic population
- Adding hs-cTnT, difference in AUC
- 0.062 (95% CI 0.038-0.086; P < 0.001)
- Adding hs-cTnI (Abbott), difference in AUC
- 0.071 (95% CI 0.046-0.097; P < 0.001)
- Adding hs-cTnI to score plus hs-cTnT
- 0.018 (95%CI 0.006-0.029; P = 0.002)
- No significant increase in normoglycemic population
99th percentile URLs, presumably healthy diabetic vs healthy population
- hs-cTnT 99th percentile higher in diabetic population, no overlap in 95% CIs
- hs-cTnI 99th percentiles very close, 95% CIs extensively overlapped
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →