Subclinical CVD affected 33.4% of adults with diabetes versus 16.1% without, and elevated hs-cTnT in diabetic adults was associated with increased all-cause mortality (HR 1.77; 95% CI 1.33-2.34).
Observational (n=10,304)
Yes
Does the presence of elevated cardiac biomarkers (hs-cTnT and NT-proBNP) predict all-cause and CVD mortality in US adults with diabetes without prior CVD?
Subclinical cardiovascular disease, indicated by elevated hs-cTnT or NT-proBNP, is highly prevalent in US adults with diabetes and is strongly associated with increased all-cause and CVD mortality.
Hazard Ratio: 1.77 (95% CI 1.33–2.34)
Background We characterized the burden and prognostic value of subclinical cardiovascular disease (CVD) assessed by cardiac biomarkers among adults with and without diabetes in the general US population. Methods and Results We measured hs-cTnT (high-sensitivity cardiac troponin T) and NT-proBNP (N-terminal pro-B-type natriuretic peptide) in stored serum samples from the 1999 to 2004 National Health and Nutrition Examination Survey. Among US adults without a history of CVD (n=10 304), we estimated the prevalence of elevated hs-cTnT (≥14 ng/L) and NT-proBNP (≥125 pg/mL) in those with and without diabetes. We examined the associations between elevated hs-cTnT and NT-proBNP with all-cause and CVD mortality after adjustment for demographics and traditional CVD risk factors. The crude prevalence of subclinical CVD (elevated hs-cTnT or NT-proBNP) was ≈2 times higher in adults with (versus without) diabetes (33.4% versus 16.1%). After age adjustment, elevated hs-cTnT, but not elevated NT-proBNP, was more common in those with diabetes, overall and across age, sex, race and ethnicity, and weight status. The prevalence of elevated hs-cTnT was significantly higher in those with longer diabetes duration and worse glycemic control. In persons with diabetes, elevated hs-cTnT and NT-proBNP were independently associated with all-cause mortality (adjusted hazard ratio HR, 1.77 95% CI, 1.33-2.34 and HR, 1.78 95% CI, 1.26-2.51) and CVD mortality (adjusted HR, 1.54 95% CI, 0.83-2.85 and HR, 2.46 95% CI, 1.31-4.60). Conclusions Subclinical CVD affects ≈1 in 3 US adults with diabetes and confers substantial risk for mortality. Routine testing of cardiac biomarkers may be useful for assessing and monitoring risk in persons with diabetes.
Fang et al. (Wed,) conducted a observational in Subclinical cardiovascular disease and diabetes (n=10,304). Elevated hs-cTnT (≥14 ng/L) vs. Non-elevated hs-cTnT was evaluated on All-cause mortality (HR 1.77, 95% CI 1.33-2.34). Subclinical CVD affected 33.4% of adults with diabetes versus 16.1% without, and elevated hs-cTnT in diabetic adults was associated with increased all-cause mortality (HR 1.77; 95% CI 1.33-2.34).
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