Prognostic value of high-sensitivity cardiac troponin for major adverse cardiovascular events in patients with diabetes: a systematic review and meta-analysis
Background High-sensitivity cardiac troponin (hs-cTn) is associated with cardiovascular outcomes in the general population, but the prognostic value of hs-cTn in the diabetic population remains inconclusive. This study aimed to systematically review current evidence regarding the association between...
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PeerJ Inc.
2023-11-01
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| author | Tiange Song Yu Lan Kecheng Li Honglang Huang Li Jiang |
| author_facet | Tiange Song Yu Lan Kecheng Li Honglang Huang Li Jiang |
| author_sort | Tiange Song |
| collection | DOAJ |
| description | Background High-sensitivity cardiac troponin (hs-cTn) is associated with cardiovascular outcomes in the general population, but the prognostic value of hs-cTn in the diabetic population remains inconclusive. This study aimed to systematically review current evidence regarding the association between hs-cTn and the prognosis of diabetic patients. Methods MEDLINE, Embase, and the Cochrane Database were searched from inception to May, 2023. Observational studies that investigated the prognostic value of hs-cTn in diabetic patients were included in this meta-analysis. Studies were excluded if they did not report outcomes of interest, or urine hs-cTn were measured. Two independent investigators extracted and analyzed the data according to the PRISMA guidelines. The primary outcome was long-term major adverse cardiovascular events (MACE). Results We included 30 cohort studies of 62,419 diabetic patients. After a median follow-up of 5 (4.1–9.5) years, the pooled results suggested elevation of hs-cTn was associated with a significantly increased risk of MACE (adjusted hazard ratio (HR) per standard deviation (SD) change 1.15, 95% CI [1.06–1.25], I2 = 0%) and heart failure (adjusted HR per SD change 1.33, 95% CI [1.08–1.63], I2 = 0%) in patients with diabetes. No significant association was found regarding the association between elevation of hs-cTn and risk of all-cause mortality (adjusted HR per SD change 1.24, 95% CI [0.98–1.57], I2 = 0%). The results of sensitivity analyses were similar in prospective cohort studies, high-quality studies, or population without major cardiovascular comorbidities at baseline. hs-cTn may represent a strong and independent predictor of MACE and heart failure in diabetic patients. Future research is warranted to determine the appropriate cutoff value for hs-cTn with different comorbidities, for instance, diabetic nephropathy, peripheral artery diseases, etc. |
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| spelling | doaj.art-1ba2eaba634f4ccc825cdec73f0369df2023-11-15T15:05:08ZengPeerJ Inc.PeerJ2167-83592023-11-0111e1637610.7717/peerj.16376Prognostic value of high-sensitivity cardiac troponin for major adverse cardiovascular events in patients with diabetes: a systematic review and meta-analysisTiange Song0Yu Lan1Kecheng Li2Honglang Huang3Li Jiang4Sichuan Provincial Key Laboratory for Human Disease Gene Study, University of Electronic Science and Technology of China, Chengdu, ChinaSichuan Provincial Key Laboratory for Human Disease Gene Study, University of Electronic Science and Technology of China, Chengdu, ChinaSichuan Provincial Key Laboratory for Human Disease Gene Study, University of Electronic Science and Technology of China, Chengdu, ChinaSichuan Provincial Key Laboratory for Human Disease Gene Study, University of Electronic Science and Technology of China, Chengdu, ChinaSichuan Provincial Key Laboratory for Human Disease Gene Study, University of Electronic Science and Technology of China, Chengdu, ChinaBackground High-sensitivity cardiac troponin (hs-cTn) is associated with cardiovascular outcomes in the general population, but the prognostic value of hs-cTn in the diabetic population remains inconclusive. This study aimed to systematically review current evidence regarding the association between hs-cTn and the prognosis of diabetic patients. Methods MEDLINE, Embase, and the Cochrane Database were searched from inception to May, 2023. Observational studies that investigated the prognostic value of hs-cTn in diabetic patients were included in this meta-analysis. Studies were excluded if they did not report outcomes of interest, or urine hs-cTn were measured. Two independent investigators extracted and analyzed the data according to the PRISMA guidelines. The primary outcome was long-term major adverse cardiovascular events (MACE). Results We included 30 cohort studies of 62,419 diabetic patients. After a median follow-up of 5 (4.1–9.5) years, the pooled results suggested elevation of hs-cTn was associated with a significantly increased risk of MACE (adjusted hazard ratio (HR) per standard deviation (SD) change 1.15, 95% CI [1.06–1.25], I2 = 0%) and heart failure (adjusted HR per SD change 1.33, 95% CI [1.08–1.63], I2 = 0%) in patients with diabetes. No significant association was found regarding the association between elevation of hs-cTn and risk of all-cause mortality (adjusted HR per SD change 1.24, 95% CI [0.98–1.57], I2 = 0%). The results of sensitivity analyses were similar in prospective cohort studies, high-quality studies, or population without major cardiovascular comorbidities at baseline. hs-cTn may represent a strong and independent predictor of MACE and heart failure in diabetic patients. Future research is warranted to determine the appropriate cutoff value for hs-cTn with different comorbidities, for instance, diabetic nephropathy, peripheral artery diseases, etc.https://peerj.com/articles/16376.pdfHigh-sensitivity cardiac troponinMajor adverse cardiovascular eventDiabetesPrognosis |
| spellingShingle | Tiange Song Yu Lan Kecheng Li Honglang Huang Li Jiang Prognostic value of high-sensitivity cardiac troponin for major adverse cardiovascular events in patients with diabetes: a systematic review and meta-analysis PeerJ High-sensitivity cardiac troponin Major adverse cardiovascular event Diabetes Prognosis |
| title | Prognostic value of high-sensitivity cardiac troponin for major adverse cardiovascular events in patients with diabetes: a systematic review and meta-analysis |
| title_full | Prognostic value of high-sensitivity cardiac troponin for major adverse cardiovascular events in patients with diabetes: a systematic review and meta-analysis |
| title_fullStr | Prognostic value of high-sensitivity cardiac troponin for major adverse cardiovascular events in patients with diabetes: a systematic review and meta-analysis |
| title_full_unstemmed | Prognostic value of high-sensitivity cardiac troponin for major adverse cardiovascular events in patients with diabetes: a systematic review and meta-analysis |
| title_short | Prognostic value of high-sensitivity cardiac troponin for major adverse cardiovascular events in patients with diabetes: a systematic review and meta-analysis |
| title_sort | prognostic value of high sensitivity cardiac troponin for major adverse cardiovascular events in patients with diabetes a systematic review and meta analysis |
| topic | High-sensitivity cardiac troponin Major adverse cardiovascular event Diabetes Prognosis |
| url | https://peerj.com/articles/16376.pdf |
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