ArticleCardiovascular diabetology2012
Clinical significance of troponin elevations in acute decompensated diabetes without clinical acute coronary syndrome.
Article in Cardiovascular diabetology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 33 citations in OpenAlex.
- Subclinical cardiac involvement during diabetic ketoacidosis at type 1 diabetes onset in youth: biomarker elevation, altered diastolic filling, and reduced global longitudinal strain: a prospective cohort study.Cardiovascular diabetology · 2026Observational
- Cardiac markers in children and adolescents at the onset of type 1 diabetes mellitus.PloS one · 2026Article
- Ischemic Dual Papillary Muscle Rupture: The Causality Dilemma.JACC. Case reports · 2025Article
- Comprehensive echocardiographic and biomarker assessment of patients with diabetic ketoacidosis.Cardiovascular diabetology · 2024Article
- Article
- Evaluation of novel biomarkers for early diagnosis of bisphenol A-induced coronary artery disease.Heliyon · 2024Article
- Significance of detecting cardiac troponin I and creatine kinase MB in critically Ill children without primary cardiac illness.Frontiers in pediatrics · 2024Article
- The Implication of Elevated Serum Myoglobin Level in Acute Diabetic Complications of Ketoacidosis and Hyperglycemic Hyperosmolar State: A Real-World Study.Diabetes, metabolic syndrome and obesity : targets and therapy · 2024Article
- Serum Troponin I Level in Children with Diabetic Ketoacidosis.The journal of Tehran Heart Center · 2022Article
- The impact of hyperglycaemic crisis episodes on long-term outcomes for inpatients presenting with acute organ injury: A prospective, multicentre follow-up study.Frontiers in endocrinology · 2022Article
- Markedly elevated troponin and NT-proBNP and myocardial dysfunction in an adolescent with severe diabetic ketoacidosis: A case report.Clinical pediatric endocrinology : case reports and clinical investigations : official journal of the Japanese Society for Pediatric Endocrinology · 2022Article
- A review of cardiac troponin I detection by surface enhanced Raman spectroscopy: Under the spotlight of point-of-care testing.Frontiers in chemistry · 2022Review
- Elevation Mechanisms and Diagnostic Consideration of Cardiac Troponins under Conditions Not Associated with Myocardial Infarction. Part 2.Life (Basel, Switzerland) · 2021Review
- Clinical characteristics and prognostic implications of diabetes and myocardial injury in patients admitted to the emergency room.BMC cardiovascular disorders · 2021Article
- Acute coronary syndrome and diabetic keto acidosis: the chicken or the egg?Annals of translational medicine · 2019Article
- Elevated Troponin I Levels in Diabetic Ketoacidosis Without Obstructive Coronary Artery Disease.Journal of the Endocrine Society · 2018Article
- Impact of acute diabetes decompensation on outcomes of diabetic patients admitted with ST-elevation myocardial infarction.Diabetology & metabolic syndrome · 2018Article
- Severe Myopericarditis in Diabetic Ketoacidosis-All Troponin are Not Myocardial Infarction.Clinical medicine insights. Case reports · 2018Article
- Association of subclinical myocardial injury with arterial stiffness in patients with type 2 diabetes mellitus.Cardiovascular diabetology · 2013Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundElevation of cardiac troponin has been documented in multiple settings without acute coronary syndrome. However, its impact on long-term cardiac outcomes in the context of acute decompensated diabetes remains to be explored.
methodsWe performed a retrospective analysis of 872 patients admitted to Temple University Hospital from 2004-2009 with DKA or HHS. Patients were included if they had cardiac troponin I (cTnI) measured within 24 hours of hospital admission, had no evidence of acute coronary syndrome and had a follow up period of at least 18 months. Of the 264 patients who met the criteria, we reviewed the baseline patient characteristics, admission labs, EKGs and major adverse cardiovascular events during the follow up period. Patients were categorized into two groups with normal and elevated levels of cardiac enzymes. The composite end point of the study was the occurrence of a major cardiovascular event (MACE) during the follow up period and was compared between the two groups.
resultsOf 264 patients, 24 patients were found to have elevated cTnI. Compared to patients with normal cardiac enzymes, there was a significant increase in incidence of MACE in patients with elevated cTnI. In a regression analysis, which included prior history of CAD, HTN and ESRD, the only variable that independently predicted MACE was an elevation in cTnI (p = 0.044). Patients with elevated CK-MB had increased lengths of hospitalization compared to the other group (p < 0.001).
conclusionsElevated cardiac troponin I in patients admitted with decompensated diabetes and without evidence of acute coronary syndrome, strongly correlate with a later major cardiovascular event. Thus, elevated troponin I during metabolic abnormalities identify a group of patients at an increased risk for poor long-term outcomes. Whether these patients may benefit from early detection, risk stratification and preventive interventions remains to be investigated.
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