Troponin in diabetic patients with and without chronic coronary artery disease.
Troponin in diabetic patients with and without chronic coronary artery disease.
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DOI：
10.1186/s12872-015-0051-z
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发表时间：
2015-07-21
影响因子：
2.1
通讯作者：
Kalil Filho R
中科院分区：
文献类型：
--
作者：
Segre CA;Hueb W;Garcia RM;Rezende PC;Favarato D;Strunz CM;Sprandel Mda C;Roggério A;Carvalho AL;Maranhão RC;Ramires JA;Kalil Filho R
在没有不稳定冠状动脉综合征的情况下，用新的高灵敏度检测方法检测到的心脏特异性肌钙蛋白可以在心血管合并症反应中慢性升高，并提供重要的预后信息。糖尿病和冠状动脉疾病都是肌钙蛋白升高的已知预测因子。目前尚不清楚与冠状动脉正常的糖尿病患者相比，糖尿病合并冠状动脉疾病患者的肌钙蛋白水平是否不同。为了研究这个问题，我们测定了两组糖尿病患者的肌钙蛋白水平：冠状动脉多支病变患者和冠状动脉造影术正常患者。我们研究了95例糖尿病患者，并比较了50例冠心病患者(平均年龄 = 63.7岁，男性58.7%)和45例冠状动脉造影术正常的对照组的血清肌钙蛋白。测定脑利钠肽和氧化应激生物标志物髓过氧化物酶、硝基酪氨酸和氧化低密度脂蛋白。糖尿病合并冠心病患者的肌钙蛋白水平高于对照组(中位数分别为12.0pg/mL(95%CI：10-16)和7.0pg/mL(95%CI：5.9-8.5)；p = 0.0001)。诊断冠心病的ROC曲线下面积为0.712，敏感性为70%，特异性为66%。血浆BNP水平和氧化应激变量(髓过氧化物酶、硝基酪氨酸和氧化低密度脂蛋白)在两组之间没有差异。在多因素分析中，性别(p = 0.04)、血糖(0.03)和肌钙蛋白I(p = 0.01)有独立的统计学意义。肌钙蛋白升高与存在多种相关心血管危险因素的糖尿病患者的慢性冠状动脉病变有关。在这一高危人群中，肌钙蛋白可能是一个生物标志物。Http://www.controlled-trials.com注册号：ISRCTN26970041
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. 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. 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. 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. http://www.controlled-trials.com Registration number:ISRCTN26970041