High-sensitivity cardiac troponin T (hs-cTnT) and I (hs-cTnI) may be useful markers for comorbidity burden in older adults with diabetes, according to study results presented at the 3rd Annual Heart in Diabetes Conference, held July 12 to 14, 2019, in Philadelphia, Pennsylvania, and simultaneously published in Clinical Cardiology.
High-sensitivity troponins are elevated in some chronic conditions. To evaluate whether levels of hs-cTnT and hs-cTnI are associated with comorbidities or mortality risk in patients with diabetes, investigators conducted a cross-sectional prospective study of participants from the Atherosclerosis Risk in Communities study (ClinicalTrials.gov Identifier: NCT00005131) from 2011 to 2013.
The researchers assessed whether elevated levels of either troponin (≥85th percentile) were linked to several comorbidities mentioned in the 2019 American Diabetes Association guidelines and mortality across comorbidity levels (<3 vs ≥3 comorbidities).
In total, 1695 adults with diabetes were included (age range, 67-89 years; 28% black; 56% women). Patients had median hs-cTnT and hs-cTnI levels of 12.0 and 3.6 ng/L, respectively. Elevated levels of hs-cTnT (≥20 ng/L) and hs-cTnI (≥7.4 ng/L) were both associated with heart failure, coronary heart disease, chronic kidney disease, and severe hypoglycemia. Elevated hs-cTnT was linked to emphysema, whereas elevated hs-cTnI was significantly associated with a history of falls for which the person was hospitalized.
Furthermore, based on data from 311 deaths over 5.7 years of follow-up, both troponins further stratified all-cause mortality risk across patients with <3 or ≥3 comorbidities.
“The American Diabetes Association guidelines recommend accounting for the burden of comorbidities in informing clinical decision-making with older adults,” wrote the researchers. “These findings support the potential use of high sensitivity troponins as informative measures of health status in guiding clinical care of older adults with diabetes.”
Tang O, Daya N, Matsushita K, et al. Association of high-sensitivity cardiac troponin T and I with comorbidities and all-cause mortality in older adults with type 2 diabetes. Presented at: 3rd Annual Heart in Diabetes Medical Conference; July 12-14, 2019; Philadelphia, PA. Abstract 0031.