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Cited by 42Acute Myocardial Infarction ResearchDiabetes, Cardiovascular Risks, and LipoproteinsCardiovascular Function and Risk Factors

Troponin in diabetic patients with and without chronic coronary artery disease

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Segre, Carlos Alexandre Wainrober, Hueb, Whady, Garcia, Rosa Maria Rahmi, Rezende, Paulo Cury, Favarato, Desiderio, Strunz, Celia Maria Cassaro, Sprandel, Marília da Costa Oliveira, Roggério, Alessandra +4 more·2015·BMC Cardiovascular Disorders
DOI 10.1186/s12872-015-0051-zPMC PMC4508806
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Abstract

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.

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  • Baseline parameters and methods used in the Ravassa and Segre studies were similar.

    “For instance, while Ravassa et al. found higher 3-NT levels in T2D patients with additional cardiovascular events, no differences were observed by Segre and colleagues although baseline parameters of the study populations and the used methods were similar [189,190].”

    From Protein oxidation - Formation mechanisms, detection and relevance as biomarkers in human diseases (2021) · cites this paper as [190]

    The Results report no significant difference in nitrotyrosine between Segre’s diabetic patients with coronary artery disease and controls (27.9 versus 28.7; p = 0.77). The Methods and Results describe Segre’s participants and assay, but our copy does not compare their baseline characteristics or methods with Ravassa’s study, so the claimed similarity is not established by this source. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • Segre et al. observed no differences in 3-NT levels in their study.

    “For instance, while Ravassa et al. found higher 3-NT levels in T2D patients with additional cardiovascular events, no differences were observed by Segre and colleagues although baseline parameters of the study populations and the used methods were similar [189,190].”

    From Protein oxidation - Formation mechanisms, detection and relevance as biomarkers in human diseases (2021) · cites this paper as [190]

  • Ravassa et al. found higher 3-NT levels in T2D patients with additional cardiovascular events.

    “For instance, while Ravassa et al. found higher 3-NT levels in T2D patients with additional cardiovascular events, no differences were observed by Segre and colleagues although baseline parameters of the study populations and the used methods were similar [189,190].”

    From Protein oxidation - Formation mechanisms, detection and relevance as biomarkers in human diseases (2021) · cites this paper as [190]

  • In T2D patients, 3-NT levels do not differ between those with and without CAD (plasma, ELISA).

    “No differences between the groups”

    From Protein oxidation - Formation mechanisms, detection and relevance as biomarkers in human diseases (2021) · cites this paper as [190]

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Research works printed but not linked: 38

  1. [2]Reichlin T Hochholzer W Bassetti S Steuer S Stelzig C Hartwiger S Early diagnosis of myocardial infarction with sensitive cardiac troponin assays N Engl J Med 2009 361 9 858 67 10.1056/NEJMoa0900428 19710484 · DOI
  2. [3]Twerenbold R Jaffe A Reichlin T Reiter M Mueller C High-sensitive troponin T measurements: what do we gain and what are the challenges? Eur Heart J 2012 33 5 579 86 10.1093/eurheartj/ehr492 22267244 · DOI
  3. [4]Sethi A Bajaj A Malhotra G Arora RR Khosia S Diagnostic accuracy of sensitive or high-sensitive troponin on presentation for myocardial infarction: a meta-analysis and systematic review Vasc Health Risk Manag 2014 10 435 50 10.2147/VHRM.S63416 25092986 PMC4115590 · DOI
  4. [5]de Lemos JA Drazner MH Omland T Ayers CR Khera A Association of troponin T detected with a highly sensitive assay and cardiac structure and mortality risk in the general population JAMA 2010 304 22 2503 12 10.1001/jama.2010.1768 21139111 PMC5621378 · DOI
  5. [6]Eggers KM Al-Shakarchi J Berglund L Lindahl B Siegbahn A Wallentin L High-sensitive cardiac troponin T and its relations to cardiovascular risk factors, morbidity, and mortality in elderly men Am Heart J 2013 166 3 541 8 10.1016/j.ahj.2013.07.004 24016505 · DOI
  6. [7]de Filippi CR de Lemos JA Christenson RH Christenson RH Gottdiener JS Kip WJ Association of serial measures of cardiac troponin T using a sensitive assay with incident heart failure and cardiovascular mortality in older adults JAMA 2010 304 22 2494 502 10.1001/jama.2010.1708 21078811 PMC3559101 · DOI
  7. [8]Saunders JT Nambi V de Lemos JA Chambless LE Virani SS Boerwinkle E Cardiac troponin T measured by a highly sensitive assay predicts coronary heart disease, heart failure, and mortality in the Atherosclerosis Risk in Communities Study Circulation 2011 123 13 1367 76 10.1161/CIRCULATIONAHA.110.005264 21422391 PMC3072024 · DOI
  8. [9]Omland T New features of troponin testing in different clinical settings J Intern Med 2010 268 3 207 17 10.1111/j.1365-2796.2010.02253.x 20626552 · DOI
  9. [10]Apple FS High-sensitivity cardiac troponin for screening large populations of healthypeople: is there risk? Clin Chem 2011 57 4 537 9 10.1373/clinchem.2011.162875 21310871 · DOI
  10. [11]Laakso M Heart in diabetes: a microvascular disease Diabetes Care 2011 34 Suppl 2 S145 9 10.2337/dc11-s209 21525446 PMC3632152 · DOI
  11. [12]Grundy SM Benjamin IJ Burke GL Chait A Eckel RH Howard BV Diabetes and cardiovascular disease: a statement for healthcare professionals from the American Heart Association Circulation 1999 100 10 1134 46 10.1161/01.CIR.100.10.1134 10477542 · DOI · Paper page
  12. [13]Kannel WB McGee DL Diabetes and cardiovascular disease The Framingham study JAMA 1979 241 19 2035 8 430798
  13. [14]Zimmet P Alberti KG Shaw J Global and societal implications of the diabetes epidemic Nature 2001 414 6865 782 7 10.1038/414782a 11742409 · DOI · Paper page
  14. [15]Eckel RH Wassef M Chait A Sobel B Barrett E King G Prevention Conference VI: Diabetes and Cardiovascular Disease: Writing Group II: pathogenesis of atherosclerosis in diabetes Circulation 2002 105 18 e138 43 10.1161/01.CIR.0000013954.65303.C5 11994264 · DOI
  15. [16]Vazzana N Ranalli P Cuccurullo C Davi G Diabetes mellitus and thrombosis Thromb Res 2012 129 3 371 7 10.1016/j.thromres.2011.11.052 22197180 · DOI
  16. [17]Makimattila S Virkamäki A Groop PH Cockcroft J Utriainenb T Fagerudd J Chronic hyperglycemia impairs endothelial function and insulin sensitivity via different mechanisms in insulin-dependent diabetes mellitus Circulation 1996 94 6 1276 82 10.1161/01.CIR.94.6.1276 8822980 · DOI
  17. [18]Giacco F Brownlee M Oxidative stress and diabetic complications Circ Res 2010 107 9 1058 70 10.1161/CIRCRESAHA.110.223545 21030723 PMC2996922 · DOI · Paper page
  18. [19]Wallace TW Abdullah SM Drazner MH Das SR Khera A McGuire DK Prevalence and determinants of troponin T elevation in the general population Circulation 2006 113 16 1958 65 10.1161/CIRCULATIONAHA.105.609974 16618821 · DOI
  19. [20]Hallén J Johansen OE Birkeland KI Gullestad L Aakhuys S Endresen K Determinants and prognostic implications of cardiac troponin T measured by a sensitive assay in type 2 diabetes mellitus Cardiovasc Diabetol 2010 9 52 10.1186/1475-2840-9-52 20843304 PMC2946276 · DOI
  20. [21]Everett BM Cook NR Magnone MC Bobadilla M Kim E Rifai N Sensitive cardiac troponin T assay and the risk of incident cardiovascular disease in women with and without diabetes mellitus: the Women’s Health Study Circulation 2011 123 24 2811 8 10.1161/CIRCULATIONAHA.110.009928 21632491 PMC3144564 · DOI
  21. [22]Axelsson A Ruwald MH Dalsgaard M Rossing K Steffensen R Iversen K Serial measurements of high-sensitivity cardiac troponin T after exercise stress test in stable coronary artery disease Biomarkers 2013 18 4 304 9 10.3109/1354750X.2013.776635 23651344 · DOI
  22. [23]Omland T de Lemos JA Sabatine MS Christophi CA Rice MM Jablonski KA A sensitive cardiac troponin T assay in stable coronary artery disease N Engl J Med 2009 361 26 2538 47 10.1056/NEJMoa0805299 19940289 PMC2997684 · DOI
  23. [24]Omland T Pfeffer MA Solomon SD de Lomos JA RØsjØ H Saltyté Benth J Prognostic value of cardiac troponin I measured with a highly sensitive assay in patients with stable coronary artery disease J Am Coll Cardiol 2013 61 12 1240 9 10.1016/j.jacc.2012.12.026 23414791 · DOI
  24. [25]Giannitsis E Spanuth E Horsch A Kleber ME Koch W Grammer TB High-sensitivity cardiac troponin T and N-terminal pro-B-type natriuretic peptide predict mortality in stable coronary artery disease: results from the Ludwigshafen Risk and Cardiovascular Health (LURIC) study Clin Chem Lab Med 2013 51 10 2019 28 10.1515/cclm-2012-0786 24072576 · DOI
  25. [26]Laufer EM Mingels AM Winkens MH Joosen IA Schellings MW Leiner T The extent of coronary atherosclerosis is associated with increasing circulating levels of high sensitive cardiac troponin T Arterioscler Thromb Vasc Biol 2010 30 6 1269 75 10.1161/ATVBAHA.109.200394 20299689 · DOI
  26. [27]Apple FS A new season for cardiac troponin assays: it’s time to keep a scorecard Clin Chem 2009 55 7 1303 6 10.1373/clinchem.2009.128363 19478023 · DOI
  27. [28]Korosoglou G Lehrke S Mueller D Hosch W Kauczor HU Humpert PM Determinants of troponin release in patients with stable coronary artery disease: insights from CT angiography characteristics of atherosclerotic plaque Heart 2011 97 10 823 31 10.1136/hrt.2010.193201 20884786 · DOI
  28. [29]Yiu KH Lau KK Zhao CT Chan YH Chen Y Zhen Z Predictive value of high-sensitivity troponin-I for future adverse cardiovascular outcome in stable patients with type 2 diabetes mellitus Cardiovasc Diabetol 2014 13 63 10.1186/1475-2840-13-63 24661773 PMC4006634 · DOI
  29. [30]Quadri G D’ascenzo F Bollati M Moretti C Sciuto F Gonella A Diffuse coronary disease: short- and long-term outcome after percutaneous coronary intervention Acta Cardiol 2013 68 2 151 60 23705557
  30. [31]Aronson D Edelman ER Revascularization for coronary artery disease in diabetes mellitus: Angioplasty, stents and coronary artery bypass grafting Rev Endocr Metab Disord 2010 11 1 75 86 10.1007/s11154-010-9135-3 20221852 PMC3076727 · DOI
  31. [32]Thygesen K Mair J Katus H Plebani M Venge P Collinson P Recommendations for the use of cardiac troponin measurement in acute cardiac care Eur Heart J 2010 31 18 2197 204 10.1093/eurheartj/ehq251 20685679 · DOI
  32. [33]Olivetti G Abbi R Quaini F Kajstura J Cheng W Nitahara JA Apoptosis in the failing human heart N Engl J Med 1997 336 16 1131 41 10.1056/NEJM199704173361603 9099657 · DOI · Paper page
  33. [34]Kociol RD Pang PS Gheorghiade M Fonarow GC O’Connor CM Felker GM Troponin elevation in heart failure prevalence, mechanisms, and clinical implications J Am Coll Cardiol 2010 56 14 1071 8 10.1016/j.jacc.2010.06.016 20863950 · DOI
  34. [35]Castelli WP, Doyle JT, Gordon T, Hames CG, Hjortland MC, Hulley SB, et al. HDL cholesterol and other lipids in coronary heart disease. The cooperative lipoprotein phenotyping study. Circulation. 1977;55(5):767–72. 191215
  35. [36]Ostrander LD Jr Lamphiear DE Carman WJ Williams GW Blood glucose and risk of coronary heart disease Arteriosclerosis 1981 1 1 33 7 10.1161/01.ATV.1.1.33 7295184 · DOI
  36. [37]Stolar M Glycemic control and complications in type 2 diabetes mellitus Am J Med 2010 123 3 Suppl S3 11 10.1016/j.amjmed.2009.12.004 20206730 · DOI · Paper page
  37. [38]Bramlage P Gitt AK Schneider S Deeg E Tschöpe D Clinical course and outcomes of type-2 diabetic patients after treatment intensification for insufficient glycaemic control – results of the 2 year prospective DiaRegis follow-up BMC Cardiovasc Disord 2014 14 162 10.1186/1471-2261-14-162 25410473 PMC4247562 · DOI
  38. [39]Jousilahti P Vartiainen E Tuomilehto J Puska P Sex, age, cardiovascular risk factors, and coronary heart disease: a prospective follow-up study of 14 786 middle-aged men and women in Finland Circulation 1999 99 9 1165 72 10.1161/01.CIR.99.9.1165 10069784 · DOI · Paper page

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Authors
Segre, C. A. W., Hueb, W., Garcia, R. M. R., Rezende, P. C., Favarato, D., Strunz, C. M. C., Sprandel, M. D. C. O., Roggério, A., Carvalho, A. L. D. O., Maranhão, R. C., Ramires, J. A. F., & Filho, R. K.
Affiliations
Universidade de São Paulo (BR)
Corresponding author
Hueb, Whady
ORCID
Venue
BMC Cardiovascular Disorders
Publisher
Springer Science and Business Media LLC
Published
2015-07-21
Volume
15
Issue
1
Pages
72-72
ISSN
1471-2261 (ISSN-L)
DOI
10.1186/s12872-015-0051-z
PMC
PMC4508806
OpenAlex
W2118619332
Cited by
42
References
1
Citations by year
2025: 2 · 2024: 5 · 2023: 6 · 2022: 7 · 2021: 8 · 2020: 3 · 2019: 4 · 2018: 2 · 2017: 3 · 2016: 2
FWCI
1.70
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Cardiovascular Disorders (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion)
Funders
Fundação de Amparo à Pesquisa do Estado de São Paulo
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
Keywords
cardiac troponin I, high-sensitivity troponin, diabetes mellitus, stable coronary artery disease, multivessel coronary artery disease, angiographically normal coronary arteries, brain natriuretic peptide, oxidative stress, myeloperoxidase, nitrotyrosine, oxidized LDL, serum glucose, cardiovascular risk factors
MeSH terms
Aged, Coronary Artery Disease, Diabetes Mellitus, Type 2, Female, Humans, Cholesterol, LDL, Male, Middle Aged, Peroxidase, Oxidation-Reduction, Risk Factors, Tyrosine, Biomarkers, Case-Control Studies, Troponin C, Natriuretic Peptide, Brain

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