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Subclinical CVD Linked to Increased Risk for Mortality in Diabetes

In HealthDay News
by Healthday

Adults with diabetes with elevated hs-cTnT and NT-proBNP have increased risk for all-cause, CVD mortality

By Elana Gotkine HealthDay Reporter

MONDAY, June 5, 2023 (HealthDay News) — For adults with diabetes, subclinical cardiovascular disease (CVD), as assessed by cardiac biomarkers, is associated with an increased risk for all-cause and CVD mortality, according to a study published online May 31 in the Journal of the American Heart Association.

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Michael Fang, Ph.D., from the Johns Hopkins Bloomberg School of Public Health in Baltimore, and colleagues estimated the prevalence of elevated high-sensitivity cardiac troponin T (hs-cTnT; ≥14 ng/L) and N-terminal pro-B-type natriuretic peptide (NT-proBNP; ≥125 pg/mL) in 10,304 U.S. adults without a history of CVD, with and without diabetes.

The researchers found that the crude prevalence of subclinical CVD (elevated hs-cTnT or NT-proBNP) was about two times higher in adults with versus those without diabetes (33.4 versus 16.1 percent). In those with diabetes, elevated hs-cTnT, but not elevated NT-proBNP, was more prevalent after age adjustment, overall and across age, sex, race and ethnicity, and weight status. Those with longer diabetes duration and worse glycemic control had a significantly higher prevalence of elevated hs-cTnT. Independent associations were seen for elevated hs-cTnT and NT-proBNP with all-cause mortality (adjusted hazard ratios, 1.77 and 1.78, respectively) and CVD mortality (adjusted hazard ratios, 1.54 and 2.46, respectively) among those with diabetes.

“If type 2 diabetes is directly causing damage to the small vessels in the heart unrelated to cholesterol plaque buildup, then cholesterol-lowering medications are not going to prevent cardiac damage,” a coauthor said in a statement. “Our research suggests that additional non-statin-related therapies are needed to lower the cardiovascular disease risk in people with type 2 diabetes.”

One author disclosed ties to the biopharmaceutical industry; reagents were donated by Abbott Laboratories, Ortho Clinical Diagnostics, Roche Diagnostics, and Siemens Healthcare Diagnostics.

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