Abstract
Diabetes, pre-diabetes, and progression of subclinical myocardial damage
Circulation (New York, N.Y.), v 129(12), pA16-A16
25 Mar 2014
Abstract
Background: Persons with hyperglycemia even below the threshold for the diagnosis of diabetes are at increased risk for cardiovascular events. The relationships of pre-diabetes and undiagnosed diabetes with progression of subclinical myocardial damage are relatively uncharacterized.
Objective: To characterize the associations of diabetes and pre-diabetes with 6-year progression of subclinical myocardial injury, as assessed by a novel highly sensitive assay for cardiac troponin T (hs-cTnT).
Methods: We conducted a prospective analysis of hs-cTnT measured at two time points, 6 years apart, in 8446 participants of the community-based ARIC Study with hs-cTnT <14 ng/L and without a history of heart disease, stroke or heart failure at baseline (1990-92). We examined the associations of pre-diabetes and diabetes defined by HbA1c or fasting glucose with 6-year change in hs-cTnT after adjustment for traditional cardiovascular risk factors. Diagnosed diabetes was defined as self-reported physician diagnosis or medication use for diabetes. We used Poisson regression to evaluate the risk of progression of hs-cTnT from non-elevated (<14 ng/L) to elevated (≥14 ng/L) (“incident elevated hs-cTnT”) at 6 years of follow-up.
Results: Baseline prevalence of elevated concentrations of hs-cTnT among persons with no diabetes (HbA1c<5.7%), prediabetes (HbA1c 5.7-6.4%), undiagnosed diabetes (≥6.5%), and diagnosed diabetes were 1.8%, 3.3%, 6.3% and 10.3%, respectively. Diagnosed diabetes, undiagnosed diabetes, and pre-diabetes were significantly associated with incident elevated hs-cTnT (Table). The associations of undiagnosed diabetes and pre-diabetes defined by diagnostic categories of HbA1c showed somewhat stronger associations compared to those clinical categories defined by fasting glucose.
Conclusions: These results provide evidence for a progressive, deleterious effect of hyperglycemia on the myocardium, even below the threshold for a diagnosis of diabetes.
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Details
- Title
- Diabetes, pre-diabetes, and progression of subclinical myocardial damage
- Creators
- Elizabeth Selvin - Johns Hopkins UniversityMariana Lazo - Johns Hopkins UniversityLu Shen - Johns Hopkins UniversityJonathan Rubin - Johns Hopkins UniversityJohn William McEvoy - Johns Hopkins UniversityRon C Hoogeveen - Baylor College of MedicineChristie M Ballantyne - Baylor College of MedicineJosef Coresh - Johns Hopkins University
- Publication Details
- Circulation (New York, N.Y.), v 129(12), pA16-A16
- Conference
- American Heart Association's Epidemiology and Prevention/Nutrition, Physical Activity, and Metabolism 2014 Scientific Sessions (San Francisco, California, United States, 18 Mar 2014–21 Mar 2014)
- Publisher
- Lippincott Williams & Wilkins, WK Health
- Resource Type
- Abstract
- Language
- English
- Academic Unit
- Urban Health Collaborative
- Other Identifier
- 991020550341704721