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Usefulness of Highly Sensitive Troponin as a Predictor of Short-Term Outcome in Patients With Diabetes Mellitus and Stable Coronary Artery Disease (from the ARTEMIS Study)

The aim of this study was to test the hypothesis that novel biomarkers may predict cardiac events in diabetic patients with stable coronary artery disease (CAD). Serum levels of highly sensitive troponin T (hs-TnT), B-type natriuretic peptide, highly sensitive C-reactive protein (hs-CRP), galectin-3... Full description

Journal Title: The American journal of cardiology 2016, Vol.117 (4), p.515-521
Main Author: Lepojärvi, E. Samuli, MD
Other Authors: Piira, Olli-Pekka, MD , Kiviniemi, Antti M., PhD , Miettinen, Johanna A., PhD , Kenttä, Tuomas, PhD , Ukkola, Olavi, MD , Tulppo, Mikko P., PhD , Huikuri, Heikki V., MD , Junttila, M. Juhani, MD
Format: Electronic Article Electronic Article
Language: English
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Publisher: United States: Elsevier Inc
ID: ISSN: 0002-9149
Link: https://www.ncbi.nlm.nih.gov/pubmed/26739392
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title: Usefulness of Highly Sensitive Troponin as a Predictor of Short-Term Outcome in Patients With Diabetes Mellitus and Stable Coronary Artery Disease (from the ARTEMIS Study)
format: Article
creator:
  • Lepojärvi, E. Samuli, MD
  • Piira, Olli-Pekka, MD
  • Kiviniemi, Antti M., PhD
  • Miettinen, Johanna A., PhD
  • Kenttä, Tuomas, PhD
  • Ukkola, Olavi, MD
  • Tulppo, Mikko P., PhD
  • Huikuri, Heikki V., MD
  • Junttila, M. Juhani, MD
subjects:
  • Abridged Index Medicus
  • Aged
  • Analysis
  • Angina pectoris
  • Biomarkers - blood
  • C-reactive protein
  • Cardiology
  • Cardiovascular
  • Care and treatment
  • Cause of Death - trends
  • Cholesterol
  • Coronary Artery Disease - blood
  • Coronary Artery Disease - complications
  • Coronary Artery Disease - mortality
  • Coronary heart disease
  • Dextrose
  • Diabetes Mellitus, Type 2 - blood
  • Diabetes Mellitus, Type 2 - complications
  • Diabetes Mellitus, Type 2 - microbiology
  • Diabetics
  • Female
  • Finland - epidemiology
  • Follow-Up Studies
  • Glucose
  • Heart
  • Heart attacks
  • Heart failure
  • Hospitalization
  • Humans
  • Male
  • Medical research
  • Medicine, Experimental
  • Metabolic disorders
  • Middle Aged
  • Natriuretic peptides
  • Patient outcomes
  • Prognosis
  • Risk Factors
  • Survival Rate - trends
  • Time Factors
  • Troponin - blood
  • Type 2 diabetes
ispartof: The American journal of cardiology, 2016, Vol.117 (4), p.515-521
description: The aim of this study was to test the hypothesis that novel biomarkers may predict cardiac events in diabetic patients with stable coronary artery disease (CAD). Serum levels of highly sensitive troponin T (hs-TnT), B-type natriuretic peptide, highly sensitive C-reactive protein (hs-CRP), galectin-3, and soluble suppressor of tumorigenicity-2 (sST2) were analyzed in 1,137 patients with CAD and with type 2 diabetes, impaired glucose tolerance, or fasting glycaemia (diabetic group) and in 649 patients with normal glucose state. Cardiac death or hospitalization for congestive heart failure was the major end point during the follow-up of 2 years. Forty patients in the diabetic group (3.5%) and 9 patients in the nondiabetic group (1.4%) reached the primary end point. High hs-TnT level (≥14 ng/l) was the strongest predictor of the primary end point with hazard ratio of 24.5 (95% confidence interval 8.7 to 69.0; p
language: eng
source:
identifier: ISSN: 0002-9149
fulltext: no_fulltext
issn:
  • 0002-9149
  • 1879-1913
url: Link


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titleUsefulness of Highly Sensitive Troponin as a Predictor of Short-Term Outcome in Patients With Diabetes Mellitus and Stable Coronary Artery Disease (from the ARTEMIS Study)
creatorLepojärvi, E. Samuli, MD ; Piira, Olli-Pekka, MD ; Kiviniemi, Antti M., PhD ; Miettinen, Johanna A., PhD ; Kenttä, Tuomas, PhD ; Ukkola, Olavi, MD ; Tulppo, Mikko P., PhD ; Huikuri, Heikki V., MD ; Junttila, M. Juhani, MD
creatorcontribLepojärvi, E. Samuli, MD ; Piira, Olli-Pekka, MD ; Kiviniemi, Antti M., PhD ; Miettinen, Johanna A., PhD ; Kenttä, Tuomas, PhD ; Ukkola, Olavi, MD ; Tulppo, Mikko P., PhD ; Huikuri, Heikki V., MD ; Junttila, M. Juhani, MD
descriptionThe aim of this study was to test the hypothesis that novel biomarkers may predict cardiac events in diabetic patients with stable coronary artery disease (CAD). Serum levels of highly sensitive troponin T (hs-TnT), B-type natriuretic peptide, highly sensitive C-reactive protein (hs-CRP), galectin-3, and soluble suppressor of tumorigenicity-2 (sST2) were analyzed in 1,137 patients with CAD and with type 2 diabetes, impaired glucose tolerance, or fasting glycaemia (diabetic group) and in 649 patients with normal glucose state. Cardiac death or hospitalization for congestive heart failure was the major end point during the follow-up of 2 years. Forty patients in the diabetic group (3.5%) and 9 patients in the nondiabetic group (1.4%) reached the primary end point. High hs-TnT level (≥14 ng/l) was the strongest predictor of the primary end point with hazard ratio of 24.5 (95% confidence interval 8.7 to 69.0; p <0.001) and remained so when adjusted for clinical variables, ejection fraction, renal, lipid, and glycemic status and other biomarkers (hazard ratio 9.9, 95% confidence interval 3.2 to 30.8; p <0.001). In the multivariate model, hs-CRP, B-type natriuretic peptide, and sST2 also predicted the primary end point in the diabetic group (p <0.01 for all). Only sST2 (p <0.001) and hs-CRP (p = 0.02) predicted the primary end point in nondiabetic group. The inclusion of hs-TnT in the model significantly improved discrimination (integrated discrimination improvement 0.050) and reclassification of the patients (net reclassification index 0.21). In conclusion, hs-TnT is a strong predictor of cardiac death or hospitalization for heart failure independently from traditional risk markers or other biomarkers in diabetic patients with stable CAD.
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languageeng
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subjectAbridged Index Medicus ; Aged ; Analysis ; Angina pectoris ; Biomarkers - blood ; C-reactive protein ; Cardiology ; Cardiovascular ; Care and treatment ; Cause of Death - trends ; Cholesterol ; Coronary Artery Disease - blood ; Coronary Artery Disease - complications ; Coronary Artery Disease - mortality ; Coronary heart disease ; Dextrose ; Diabetes Mellitus, Type 2 - blood ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - microbiology ; Diabetics ; Female ; Finland - epidemiology ; Follow-Up Studies ; Glucose ; Heart ; Heart attacks ; Heart failure ; Hospitalization ; Humans ; Male ; Medical research ; Medicine, Experimental ; Metabolic disorders ; Middle Aged ; Natriuretic peptides ; Patient outcomes ; Prognosis ; Risk Factors ; Survival Rate - trends ; Time Factors ; Troponin - blood ; Type 2 diabetes
ispartofThe American journal of cardiology, 2016, Vol.117 (4), p.515-521
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2Kiviniemi, Antti M., PhD
3Miettinen, Johanna A., PhD
4Kenttä, Tuomas, PhD
5Ukkola, Olavi, MD
6Tulppo, Mikko P., PhD
7Huikuri, Heikki V., MD
8Junttila, M. Juhani, MD
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0Usefulness of Highly Sensitive Troponin as a Predictor of Short-Term Outcome in Patients With Diabetes Mellitus and Stable Coronary Artery Disease (from the ARTEMIS Study)
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descriptionThe aim of this study was to test the hypothesis that novel biomarkers may predict cardiac events in diabetic patients with stable coronary artery disease (CAD). Serum levels of highly sensitive troponin T (hs-TnT), B-type natriuretic peptide, highly sensitive C-reactive protein (hs-CRP), galectin-3, and soluble suppressor of tumorigenicity-2 (sST2) were analyzed in 1,137 patients with CAD and with type 2 diabetes, impaired glucose tolerance, or fasting glycaemia (diabetic group) and in 649 patients with normal glucose state. Cardiac death or hospitalization for congestive heart failure was the major end point during the follow-up of 2 years. Forty patients in the diabetic group (3.5%) and 9 patients in the nondiabetic group (1.4%) reached the primary end point. High hs-TnT level (≥14 ng/l) was the strongest predictor of the primary end point with hazard ratio of 24.5 (95% confidence interval 8.7 to 69.0; p <0.001) and remained so when adjusted for clinical variables, ejection fraction, renal, lipid, and glycemic status and other biomarkers (hazard ratio 9.9, 95% confidence interval 3.2 to 30.8; p <0.001). In the multivariate model, hs-CRP, B-type natriuretic peptide, and sST2 also predicted the primary end point in the diabetic group (p <0.01 for all). Only sST2 (p <0.001) and hs-CRP (p = 0.02) predicted the primary end point in nondiabetic group. The inclusion of hs-TnT in the model significantly improved discrimination (integrated discrimination improvement 0.050) and reclassification of the patients (net reclassification index 0.21). In conclusion, hs-TnT is a strong predictor of cardiac death or hospitalization for heart failure independently from traditional risk markers or other biomarkers in diabetic patients with stable CAD.
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5C-reactive protein
6Cardiology
7Cardiovascular
8Care and treatment
9Cause of Death - trends
10Cholesterol
11Coronary Artery Disease - blood
12Coronary Artery Disease - complications
13Coronary Artery Disease - mortality
14Coronary heart disease
15Dextrose
16Diabetes Mellitus, Type 2 - blood
17Diabetes Mellitus, Type 2 - complications
18Diabetes Mellitus, Type 2 - microbiology
19Diabetics
20Female
21Finland - epidemiology
22Follow-Up Studies
23Glucose
24Heart
25Heart attacks
26Heart failure
27Hospitalization
28Humans
29Male
30Medical research
31Medicine, Experimental
32Metabolic disorders
33Middle Aged
34Natriuretic peptides
35Patient outcomes
36Prognosis
37Risk Factors
38Survival Rate - trends
39Time Factors
40Troponin - blood
41Type 2 diabetes
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titleUsefulness of Highly Sensitive Troponin as a Predictor of Short-Term Outcome in Patients With Diabetes Mellitus and Stable Coronary Artery Disease (from the ARTEMIS Study)
authorLepojärvi, E. Samuli, MD ; Piira, Olli-Pekka, MD ; Kiviniemi, Antti M., PhD ; Miettinen, Johanna A., PhD ; Kenttä, Tuomas, PhD ; Ukkola, Olavi, MD ; Tulppo, Mikko P., PhD ; Huikuri, Heikki V., MD ; Junttila, M. Juhani, MD
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1Aged
2Analysis
3Angina pectoris
4Biomarkers - blood
5C-reactive protein
6Cardiology
7Cardiovascular
8Care and treatment
9Cause of Death - trends
10Cholesterol
11Coronary Artery Disease - blood
12Coronary Artery Disease - complications
13Coronary Artery Disease - mortality
14Coronary heart disease
15Dextrose
16Diabetes Mellitus, Type 2 - blood
17Diabetes Mellitus, Type 2 - complications
18Diabetes Mellitus, Type 2 - microbiology
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38Survival Rate - trends
39Time Factors
40Troponin - blood
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5Ukkola, Olavi, MD
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8Junttila, M. Juhani, MD
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abstractThe aim of this study was to test the hypothesis that novel biomarkers may predict cardiac events in diabetic patients with stable coronary artery disease (CAD). Serum levels of highly sensitive troponin T (hs-TnT), B-type natriuretic peptide, highly sensitive C-reactive protein (hs-CRP), galectin-3, and soluble suppressor of tumorigenicity-2 (sST2) were analyzed in 1,137 patients with CAD and with type 2 diabetes, impaired glucose tolerance, or fasting glycaemia (diabetic group) and in 649 patients with normal glucose state. Cardiac death or hospitalization for congestive heart failure was the major end point during the follow-up of 2 years. Forty patients in the diabetic group (3.5%) and 9 patients in the nondiabetic group (1.4%) reached the primary end point. High hs-TnT level (≥14 ng/l) was the strongest predictor of the primary end point with hazard ratio of 24.5 (95% confidence interval 8.7 to 69.0; p <0.001) and remained so when adjusted for clinical variables, ejection fraction, renal, lipid, and glycemic status and other biomarkers (hazard ratio 9.9, 95% confidence interval 3.2 to 30.8; p <0.001). In the multivariate model, hs-CRP, B-type natriuretic peptide, and sST2 also predicted the primary end point in the diabetic group (p <0.01 for all). Only sST2 (p <0.001) and hs-CRP (p = 0.02) predicted the primary end point in nondiabetic group. The inclusion of hs-TnT in the model significantly improved discrimination (integrated discrimination improvement 0.050) and reclassification of the patients (net reclassification index 0.21). In conclusion, hs-TnT is a strong predictor of cardiac death or hospitalization for heart failure independently from traditional risk markers or other biomarkers in diabetic patients with stable CAD.
copUnited States
pubElsevier Inc
pmid26739392
doi10.1016/j.amjcard.2015.11.038