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Tanriverdi O, Askin L. Association of high-sensitivity troponin T with left ventricular dysfunction in prediabetes. Acta Cardiol 2024:1-6. [PMID: 38884420 DOI: 10.1080/00015385.2024.2365605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 06/02/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND Impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) are an increasingly serious problem worldwide. Tissue Doppler imaging (TDI), a non-invasive technique, may evaluate both systolic and diastolic function during the first phases of cardiovascular disease (CVD). High-sensitivity cardiac troponin T (hs-cTnT) can detect subclinical myocardial injury in asymptomatic prediabetic patients. AIM We aimed to investigate the relationship between left ventricular (LV) function and hs-cTnT in prediabetic patients. METHODS Between 1 October 2021 and 1 October 2022, we recruited 96 prediabetic and an equal number of age- and gender-matched healthy volunteers prospectively. TDI was used to evaluate both systolic and diastolic functions. Hs-cTnT levels were obtained and compared between groups. RESULTS It was found that the values for mitral annular plane systolic excursion (MAPSE), E, the rapid filling wave, E/Em, and the peak annular velocities of systolic excursion in the ejection period (Sm) were all significantly higher in these patients compared to healthy individuals (p < .001). Hs-cTnT was an independent predictor of left ventricular diastolic dysfunction (LVDD) and left ventricular systolic dysfunction (LVSD) (odds ratio [OR] = 2.625, 95% confidence interval [CI] = 1.324-4.308, p < .001, and OR = 1.922, 95% CI = 0.454-3.206, p = .004). CONCLUSIONS Prediabetics had higher hs-cTnT levels than controls. We showed that LVSD and LVDD functions were negatively affected in prediabetic patients. Our results proved that hs-cTnT levels may be associated with subclinical LV dysfunction in prediabetes.
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Affiliation(s)
- Okan Tanriverdi
- Department of Cardiology, Siirt Education and Research Hospital, Siirt, Turkey
| | - Lutfu Askin
- Department of Cardiology, Gaziantep Islamıc Science and Technology University, Gaziantep, Turkey
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Fatemi A, Zahedi M, Yazdooei Y, Daei M, Ansari MM, Sohrabi A, Azizinejad A, Hssanpour MR, Behrouzifar M, Babapour H. Association between high-sensitive cardiac troponin level and coronary artery disease: A systematic review and meta-analysis. JRSM Cardiovasc Dis 2023; 12:20480040231220094. [PMID: 38107554 PMCID: PMC10722913 DOI: 10.1177/20480040231220094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/15/2023] [Accepted: 11/24/2023] [Indexed: 12/19/2023] Open
Abstract
Background and objectives Previous studies suggest a link between high-sensitive cardiac troponin (hs-cTn) levels and coronary artery disease (CAD). However, the nature of this relationship is disputed. To address this, we conducted a study to gather and assess evidence on the association between hs-cTn and CAD prediction. Data sources Studies were systematically searched and collected from four databases and different types of gray literature to cover all available evidence. After the screening, the selected articles' quality and risk of bias assessment were evaluated. Synthesis method Meta-analysis calculated std. mean difference on the extracted data. Furthermore, heterogeneity, sensitivity, subgroups, and publication bias analyses were assessed. Results Twenty-two studies were included in this systematic review, with a total of 844 cases and 2101 control people. The results of the meta-analysis on nine studies showed a significant and positive association between hs-cTn levels and CAD (pooled std. mean difference = 0.44; 95% confidence interval = 0.14-0.73; p < 0.003), with no publication bias (p = 0.9170). Among subgroups, std. mean differences were notably different only when the data were stratified by region or risk of bias; however, subgroup analysis could not determine the source of heterogeneity. Conclusions Available prospective studies indicate a strong association of hs-cTn with the risk of CAD and significant improvements in CAD prediction. Further investigations in both molecular and clinical fields with proper methodology and more detailed information are needed to discover more evidence and underlying mechanisms to clear the interactive aspects of hs-cTn level in CAD patients.
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Affiliation(s)
- Alireza Fatemi
- Department of Medical Ethics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mahdi Zahedi
- Department of cardiology, school of medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Yasmin Yazdooei
- Department of Medical Ethics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Daei
- Alborz university of medical sciences, Alborz, Iran
| | | | - Ahmad Sohrabi
- Infectious Diseases Research Center, Golestan University of Medical Sciences, Gorgan, Iran
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McHugh MC, Diercks DB. Interpreting High-Sensitive Troponins in Patients with Hypertension. Curr Hypertens Rep 2022; 24:349-352. [PMID: 35716248 DOI: 10.1007/s11906-022-01197-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE OF REVIEW As the high-sensitivity cardiac troponin (hs-cTn) becomes more broadly used, physicians must understand the strengths and limitations of using the hs-cTn in the hypertensive population. RECENT FINDINGS The most common cause of hs-cTn elevation is cardiac myocyte injury and death; alternate mechanisms for hs-cTn elevation in the absence of cardiac myocyte death are not clearly understood. Hs-cTn elevation has been found in significant proportions of patients with asymptomatic hypertension, in patients with acute hypertensive crisis, and has even been used to predict patients who will go on to develop hypertension. While the mechanisms remain undefined, there is evidence that elevations in hs-cTn are associated with both short- and long-term morbidity and mortality. While ongoing research further defines the relationship between hypertension and hs-cTn, the emergency medicine physician must make clinical decisions today regarding the utility of this increasingly used biomarker. Given the current evidence, clinical context must be utilized including a complete clinical picture, EKGs findings, and importantly serial hs-cTn when needed to establish whether myocardial injury or myocardial infarction is occurring.
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Affiliation(s)
- Mary C McHugh
- Department of Emergency Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard E4.300, Dallas, TX, 75390, USA.
| | - Deborah B Diercks
- Department of Emergency Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard E4.300, Dallas, TX, 75390, USA
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Clinical importance of high- sensitivity troponin T in patients without coronary artery disease. North Clin Istanb 2020; 7:305-310. [PMID: 32478307 PMCID: PMC7251271 DOI: 10.14744/nci.2019.71135] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 09/13/2019] [Indexed: 11/20/2022] Open
Abstract
Cardiac troponin is the preferred biomarker for the diagnosis of the acute coronary syndrome (ACS), but many other diseases can be identified with elevated troponin levels in the absence of ACS. The recent development of a high-sensitive cardiac troponin T (hs-cTnT) assay permits the detection of very low levels of cTnT. The use of hs-cTnT assay has emerged as a tool for identifying high-risk individuals for primary preventive treatment and can detect subclinical injury in asymptomatic patients. Hs-cTnT analyses are generally related to ischemia in the literature. Thus, we made an evaluation of hs-cTnT analysis in non-coronary patients, which may contribute to the literature.
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Jespersen MM, Munk Jensen SS, Harbak J, Jeppesen KF, Revsholm J, Nybo M. Can High-Sensitivity Troponins Predict Future Hypertension? A Systematic Literature Review. Scandinavian Journal of Clinical and Laboratory Investigation 2019; 79:613-618. [PMID: 31651192 DOI: 10.1080/00365513.2019.1683765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Hypertension (HT) is associated with cardiovascular events and increased mortality, and identification of persons at risk in due time is therefore important. Finding a biomarker to identify those at risk will enable early preventive treatment, and high-sensitivity cardiac troponin (hs-cTn) seems to be a highly relevant candidate. To gather the existing knowledge on the association between hs-cTn and future HT, a systematic literature review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) reporting guidelines and using the PICOS system. Medline was searched until August 2018. Of 45 extracted papers, eleven papers were eligible for the study. None were randomized controlled trials. Three studies assessed hs-cTnI, eight studies assessed hs-cTnT. All studies found statistically significant associations between hs-cTn concentrations and future HT, but the studies included different types of blood pressure (diastolic, systolic, diurnal). Due to differences in troponin assay construction and test capability, a direct comparison of test performance in terms of specificity, sensitivity and predictive values was not possible, and a specific hs-cTn cutoff value for HT prediction could therefore not be defined. Furthermore, a number of conditions known to affect troponin concentrations (e.g. gender, renal function, and co-morbidities) were not sufficiently studied. All retrieved studies found significant associations between hs-cTn concentrations and future HT; although the findings are promising, the studies were too heterogeneous, and many conditions affecting troponin concentrations needs investigation at these low concentrations before hs-cTn can be considered a useful HT predictor.
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Affiliation(s)
- Mette M Jespersen
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
| | - Simon S Munk Jensen
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
| | - Jonathan Harbak
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
| | - Kristian F Jeppesen
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
| | - Jesper Revsholm
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
| | - Mads Nybo
- Clinical Diagnostics Department, Hospital of Southwest Jutland, Odense University Hospital, Odense, Denmark
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Hidru TH, Yang X, Xia Y, Ma L, Li HH. The relationship between Plasma Markers and Essential Hypertension in Middle-aged and Elderly Chinese Population: A Community Based Cross-sectional Study. Sci Rep 2019; 9:6813. [PMID: 31048753 PMCID: PMC6497653 DOI: 10.1038/s41598-019-43278-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 04/16/2019] [Indexed: 12/16/2022] Open
Abstract
Plasma markers have been continuously advocated as pointers to estimate the long-term risk of cardiovascular disease in the general population. We examined the relationship between plasma high-sensitivity C-reactive protein (hs-CRP), homocysteine (Hcy), high-sensitivity cardiac troponin T (hs-cTnT), N-terminal prohormone of brain natriuretic peptide (NT-proBNP), 25-Hydroxyvitamin D (25OHD), glycosylated hemoglobin A1c (HbA1c), and serum uric acid (SUA) levels and hypertension in middle and old aged population. A total of 2624 Chinese (62.02 ± 5.73 years old) were recruited into a population-based, cross-sectional study. Plasma hs-CRP, Hcy, HbA1c, and SUA levels were significantly higher in the hypertension group compared with control in the entire population and men (P = 0.05 for all). We observed a positive association between the highest quartiles of Hcy, NT-proBNP, HBA1c concentrations, and the prevalence of hypertension, OR (95% CI) = 1.48 (1.16–1.90), 1.62 (1.27–2.07) and 1.94 (1.49–2.52), respectively. The multivariable-adjusted OR of hypertension for the fourth versus the first quartile of homocysteine were 2.00 and 1.39 in men and women, respectively. In conclusion, our study found an independent and robust association between elevated Hcy, NT-ProBNP, and HBA1c levels and prevalence of hypertension in the middle-aged and elderly Chinese population. A follow-up study is necessary to endorse the observed association.
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Affiliation(s)
| | - Xiaolei Yang
- Department of Cardiology, Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Yunlong Xia
- Department of Cardiology, Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Li Ma
- School of Public Health, Dalian Medical University, Dalian, 116044, China.
| | - Hui-Hua Li
- School of Public Health, Dalian Medical University, Dalian, 116044, China. .,Department of Cardiology, Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China.
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Association of High-Sensitivity Troponin T With Left Ventricular Dysfunction in Ankylosing Spondylitis. J Clin Rheumatol 2018; 26:87-93. [PMID: 30418346 DOI: 10.1097/rhu.0000000000000951] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Ankylosing spondylitis (AS) is a systemic inflammatory disease, and cardiac dysfunction has not been clearly described clinically. High-sensitivity cardiac troponin T (hs-cTnT) is a noninvasive marker for subclinical myocardial injury. OBJECTIVE In this study, we aimed to investigate any relationship between hs-cTnT and left ventricular (LV) function evaluated via tissue Doppler imaging in AS patients with no known cardiac risk factor. METHODS Our study used a cross-sectional case protocol design and was conducted between January 2016 and June 2016. In total, 40 AS patients (17 females and 23 males) were age and sex matched with healthy volunteers (20 females and 20 males) and enlisted for this study. Detailed transthoracic echocardiography was performed, and tissue Doppler imaging was used to assess systolic and diastolic functions. High-sensitivity cardiac troponin T levels were measured and compared between 2 groups. RESULTS Compared with control subjects, AS patients had lower early (Em)/late (Am) diastolic myocardial velocities, mitral annular plane systolic excursion, and end-diastolic distance from the mitral annulus to the LV apex. Conversely, they had greater systolic myocardial velocity (Sm), isovolumetric relaxation time, and displacement index (p < 0.001, for all). Higher hs-cTnT levels were measured in AS patients (0.45 ± 0.22 vs. 1.11 ± 0.27, p < 0.001), and multivariate logistic regression analyses revealed that hs-cTnT was an independent predictor of LV diastolic dysfunction in AS patients. CONCLUSIONS These data show that AS patients had impaired LV functions and increased hs-cTnT levels. Tissue Doppler imaging may be a useful tool for detection of early functional LV abnormalities, and hs-cTnT may be valuable biomarker of diastolic LV dysfunction in AS patients.
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