The prognostic value of high-sensitivity cardiac troponin t in diabetes patients without coronary artery disease

Abstract

Abstract Background High-Sensitivity Cardiac Troponin T (hs-cTnT) is associated with poor prognosis in patients with Diabetes mellitus (DM). However, whether it remains a valuable index for risk stratification in DM patients without coronary artery disease (CAD) is not yet determined. Objective To assess the association between hs-cTnT and follow-up mortality among patients with DM but without CAD in different renal function status. Methods 2,774 patients with DM but without CAD were enrolled from the Cardiorenal Improvement II (CIN-II) Study and were divided into three groups according to tertiles of hs-cTnT levels (low, intermediate and high). The associations between hs-cTnT and all-cause mortality and Cardiovascular mortality was detected by Cox regression and Fine-Gray models, respectively. Subgroup analysis was performed in patients with different renal function status. Results During a median follow-up of 3.96 (interquartile range: 2.45 to 5.79) years, 246 (8.9%) patients died and 134 (4.8%) died from cardiovascular disease (mean age: 62.6±9.5 years; 50.4% female) among 2,774 patients. Compared to the low tertile of hs-cTnT, the high tertile of hs-cTnT increased 2.19-fold risk of all-cause mortality in DM patients without CAD (HR: 3.19, 95% CI: 2.15-4.71; P < 0.001) and increased 4.89-fold risk of cardiovascular mortality (HR: 5.89, 95% CI: 3.08-11.28; P < 0.001). Consistent results were only found in patients with eGFR >60 mL/min/1.73 m2 while the association between HS-TnI and mortality was insignificant in patients with eGFR≤60 mL/min/1.73 m2. Conclusions The present study demonstrates that for patients with eGFR >60 mL/min/1.73 m2, the high level of hs-cTnT is still associated with an increased risk of follow-up mortality in patients with diabetes, even without CAD.Foreset plots