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Study ‘opens the door’ to troponin, diabetes link

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Valerie Neff Newitt

May 2017—Clinicians and laboratories have only begun to wade into the depths of the FDA’s long-awaited clearance of a new-generation, high-sensitivity cardiac troponin T (hs-cTnT) assay for rapid diagnosis of acute myocardial infarction. Roche’s Elecsys TnT Gen 5 STAT assay received just such clearance in January. Yet researchers are already deep into investigations that may float new opportunities for high-sensitivity troponin T testing to the surface of medical diagnostics.

One such effort, carried out by investigators from the Johns Hopkins Welch Center for Prevention, Epidemiology and Clinical Research, demonstrated that high levels of hs-cTnT may also indicate a substantial risk factor for incident diabetes and cardiovascular disease.

Dr. Whelton

Dr. Whelton

The prospective study, “High-sensitivity cardiac troponin T (hs-cTnT) as a predictor of incident diabetes in the Atherosclerosis Risk in Communities (ARIC) study” (Diabetes Care. 2017;40[2]:261–269), emerged from “other excellent studies out of ARIC showing a strong relationship between troponin and cardiovascular outcomes,” says lead investigator Seamus Whelton, MD, MPH, Pollin cardiovascular prevention fellow at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease.

“We have known there is an overlap between diabetes and cardiovascular disease and that diabetes is a strong risk factor for CVD,” he tells CAP TODAY. “We wanted to utilize hs-cTnT because the subclinical cardiac microvascular damage it represents may be at least partially due to hyperglycemia, and hs-cTnT may serve as a marker of the cumulative long-term exposure to pathophysiologic changes that occur before diabetes is diagnosed. This could be one reason why glucose-lowering trials in diabetes have not, in general, shown a reduction in cardiovascular outcome.”

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