Abstract 14363: Diabetes Duration and Subclinical Myocardial Injury: The Atherosclerosis Risk in Communities Study (ARIC)

Abstract

Introduction: Diabetes exerts adverse effects on the heart, and a longer diabetes duration is associated with greater heart failure risk. The association of diabetes duration with subclinical myocardial injury is unknown. Hypothesis: Longer duration of diabetes is associated with a higher likelihood of myocardial injury, as reflected by elevated levels of high sensitivity cardiac troponin T (hs-cTnT). Methods: We performed a cross-sectional analysis of 9,243 participants without heart failure or coronary heart disease (mean age 63, 58% female, 20% Black) at ARIC Visit 4 (1996-98). Diabetes duration was calculated based on diabetes status at Visits 1 (1987-89) through 4, with additional use of self-reported age of diabetes diagnosis for those with a diagnosis prior to Visit 1. We used logistic regression to determine the association of diabetes duration with elevated (≥14 ng/L) and measurable (≥5 ng/L) hs-cTnT, adjusted for demographics and cardiovascular risk factors. Results: The prevalence of elevated hs-cTnT was higher in persons with longer diabetes duration, from 5% among those without diabetes, to 9% for those with diabetes 0-<5 years, up to 31% among those with diabetes for 15 years (p<0.0001). There was a robust association between longer diabetes duration and myocardial injury, with a diabetes duration of 15 years: adjusted OR 6.39 (95% CI 4.17-9.79) for elevated hs-cTnT compared to no diabetes ( Figure ). Diabetes duration of 15 years was also associated with measurable hs-cTnT (OR 2.83 [95% CI: 1.92-4.17], relative to no diabetes). Among those with diabetes, each additional 5 years of diabetes duration was associated with higher odds of elevated hs-cTnT (OR 1.46, 95% CI 1.35-1.57). Conclusions: Longer diabetes duration is strongly associated with subclinical myocardial injury. Interventional studies are needed to assess whether prevention and delay of diabetes onset can mitigate early myocardial damage.