Subclinical Cardiovascular Disease in US Adults With and Without Diabetes
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‐t...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-06-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.122.029083 |
| _version_ | 1797810199802675200 |
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| author | Michael Fang Dan Wang Olive Tang John William McEvoy Justin B. Echouffo‐Tcheugui Robert H. Christenson Elizabeth Selvin |
| author_facet | Michael Fang Dan Wang Olive Tang John William McEvoy Justin B. Echouffo‐Tcheugui Robert H. Christenson Elizabeth Selvin |
| author_sort | Michael Fang |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-13T07:04:39Z |
| format | Article |
| id | doaj.art-9b68e67709534ac68a42e144627002e5 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-03-13T07:04:39Z |
| publishDate | 2023-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-9b68e67709534ac68a42e144627002e52023-06-06T12:15:47ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802023-06-01121110.1161/JAHA.122.029083Subclinical Cardiovascular Disease in US Adults With and Without DiabetesMichael Fang0Dan Wang1Olive Tang2John William McEvoy3Justin B. Echouffo‐Tcheugui4Robert H. Christenson5Elizabeth Selvin6Johns Hopkins University Baltimore MDJohns Hopkins University Baltimore MDJohns Hopkins University Baltimore MDJohns Hopkins University Baltimore MDJohns Hopkins University Baltimore MDUniversity of Maryland Medical Center Baltimore MDJohns Hopkins University Baltimore MDBackground 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.https://www.ahajournals.org/doi/10.1161/JAHA.122.029083cardiac troponindiabetesNT‐proBNPpopulation‐based studyscreening |
| spellingShingle | Michael Fang Dan Wang Olive Tang John William McEvoy Justin B. Echouffo‐Tcheugui Robert H. Christenson Elizabeth Selvin Subclinical Cardiovascular Disease in US Adults With and Without Diabetes Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease cardiac troponin diabetes NT‐proBNP population‐based study screening |
| title | Subclinical Cardiovascular Disease in US Adults With and Without Diabetes |
| title_full | Subclinical Cardiovascular Disease in US Adults With and Without Diabetes |
| title_fullStr | Subclinical Cardiovascular Disease in US Adults With and Without Diabetes |
| title_full_unstemmed | Subclinical Cardiovascular Disease in US Adults With and Without Diabetes |
| title_short | Subclinical Cardiovascular Disease in US Adults With and Without Diabetes |
| title_sort | subclinical cardiovascular disease in us adults with and without diabetes |
| topic | cardiac troponin diabetes NT‐proBNP population‐based study screening |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.122.029083 |
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