Adverse outcomes for type 2 patients with heart disease and abnormal troponin levels

Patients with type 2 diabetes and coronary heart disease are more likely to have adverse cardiovascular outcomes if they have high cardiac troponin T levels, a new study finds.
These results were observed from an additional study of the BARI 2D trial by Brigham and Women’s Hospital, which examined troponin T concentrations in 2,895 type 2 patients with stable ischemic heart disease.
Troponin T is a regulatory protein that is known to be associated with increased risk of heart problems. This study looked specifically at its relevance within type 2 diabetes patients.
In BARI 2D, the patients had mild to no symptoms of angina, and were selected either for coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI). CABG and PCI are common surgical treatments for angina.
After five years, there were no differences in the rate of cardiovascular death or stroke between patients who receive prompt revascularisation (CABG or PCI) plus intensive medical therapy, or medical therapy alone. Medical therapy involves taking antianginal drugs.
In this new analysis, all 2,895 patients were observed to have detectable troponin before the study, while 39.3 per cent had abnormal levels. During the five-year follow-up, patients with higher troponin were more likely to die from adverse cardiovascular outcomes.
This association remained after severity of diabetes, cardiovascular risk factors and renal function were all assessed.
Brendan M. Everett, MD, MPH, Brigham and Women’s Hospital, and colleagues reported the findings suggest: “that high-sensitivity cardiac troponin T concentration is a powerful prognostic marker in patients who have both type 2 diabetes and stable ischemic heart disease.”