Subclinical CVD Linked to Increased Risk for Mortality in Diabetes

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.

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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