Cardiac troponin I concentrations in people presenting with diabetic ketoacidosis

2007 ◽  
Vol 44 (4) ◽  
pp. 391-393 ◽  
Author(s):  
J Geddes ◽  
K A Deans ◽  
A Cormack ◽  
D Motherwell ◽  
K Paterson ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Ketoacidosis ◽  
Cardiac Troponin ◽  
Large Scale ◽  
Troponin I ◽  
Wide Spectrum ◽  
Cardiac Troponin I ◽  
Medical Disorders ◽  
Beta Hydroxybutyrate

Background: Elevated troponin concentrations may be observed in a wide spectrum of medical disorders in people without evidence of overt ischaemic heart disease. The prospective relationship between serum cardiac troponin I (cTnI) and diabetic ketoacidosis (DKA) has not been examined in adults. Methods: Forty patients (14 male and 26 female) with type 1 diabetes were recruited. cTnI, creatine kinase (CK), cystatin C and beta-hydroxybutyrate were measured on admission and at 24, 48 and 72 h post-admission. Daily electrocardiographs were also performed. Results: Four out of forty subjects presenting with DKA had an increase in cTnI (median (SD) 0.06 (0.31) μg/L). One of the subjects had multiple possible reasons for the elevated cTnI concentration. However, the other three subjects had no obvious precipitating factors. This cohort underwent echocardiography and thallium-201 scintigraphy, which revealed no abnormalities. Conclusions: Minor troponin elevations appear to occur in a small number of subjects with type 1 diabetes presenting with DKA. The clinical relevance of this at this stage remains unknown and further large-scale studies are suggested.

Increased Cardiac Troponin I Concentration in Diabetic Ketoacidosis

2004 ◽  
Vol 17 (8) ◽  
Author(s):  
M.E. Atabek ◽  
O. Pirgon ◽  
B. Oran ◽  
I. Erkul ◽  
S. Kurtoglu
Keyword(s):  
Diabetic Ketoacidosis ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Cardiac Troponin I

scholarly journals Diabetic Ketoacidosis and Related Events With Sotagliflozin Added to Insulin in Adults With Type 1 Diabetes: A Pooled Analysis of the inTandem 1 and 2 Studies

2020 ◽  
Author(s):  
Anne L. Peters ◽  
Darren K. McGuire ◽  
Thomas Danne ◽  
Jake A. Kushner ◽  
Helena W. Rodbard ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Ketoacidosis ◽  
Risk Mitigation ◽  
Pooled Analysis ◽  
Once Daily ◽  
Adjusted Incidence Rate ◽  
Beta Hydroxybutyrate ◽  
Design And Methods ◽  
Adjusted Incidence

<b>Objective: </b>To evaluate incidence and risk factors for diabetic ketoacidosis (DKA) and related adverse events (AEs) in adults with type 1 diabetes treated with sotagliflozin adjunctive to insulin. <p><b>Research Design and Methods: </b>Data from two identically designed, 52-week, randomized studies were pooled and analyzed for DKA, changes in beta-hydroxybutyrate (BHB), and percentage of patients with BHB >0.6 and >1.5 mmol/L; patients were administered placebo, sotagliflozin 200 mg, or sotagliflozin 400 mg once daily. </p> <p><b>Results:</b> A total of 191 ketosis-related AEs were reported; 98 underwent adjudication. Of these, 37 (36 patients) were adjudicated as DKA, with an exposure-adjusted incidence rate of 0.2, 3.1, and 4.2 events per 100 patient-years for placebo, sotagliflozin 200 mg, and sotagliflozin 400 mg. No patient died from a DKA event. From a baseline BHB of ~0.13 mmol/L, sotagliflozin treatment led to a small median increase over 52 weeks (≤0.05 mmol/L at all time points). Approximately 47% and 7% of sotagliflozin-treated patients had ≥1 BHB measurement >0.6 mmol/L and >1.5 mmol/L (vs 20% and 2% of placebo-treated patients). Subsequent to the implementation of a risk mitigation plan, annualized DKA incidence was lower versus pre-implementation in both the sotagliflozin 200-mg and 400-mg groups. </p> <p><b>Conclusion:</b> In patients with type 1 diabetes, confirmed DKA incidence increased when sotagliflozin was added to insulin compared with insulin alone. A lower incidence of DKA was observed following the implementation of an enhanced risk mitigation plan, suggesting that this risk can be managed with patient education.</p>

scholarly journals Developing Sensitive Golden Plate Biosensor for Early Detection of Serum Cardiac Troponin I as Diagnostic Biomarkers

2018 ◽  
Author(s):  
Said Moselhy ◽  
Ehab Mostafa ◽  
Abdulrahman Almalki ◽  
Taha Kumosani ◽  
Youssri Soliman ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Troponin ◽  
Healthy Subjects ◽  
Large Scale ◽  
Troponin I ◽  
Cardiac Troponin I ◽  
Diagnostic Biomarkers ◽  
Elisa Technique ◽  
Serum Cardiac Troponin ◽  
Ctni Level

Rapid diagnosis of acute myocardial infarction is critical for intervention and treatment to decrease morbidity and mortality. For this reasons, this study aimed to design a sensitive biosensor for cardiac troponin I (cTnI) for early prediction and intervention. The sensor was designed from golden plate immobilized with anti- cTnI antibody conjugated with horseradish peroxidase (HRP) enzyme. The rate of degradation of H2O2 is directly related to serum cTnI level. Serum cTnI level was quantified from 3 studied groups including; healthy subjects and patients with ischemic heart (IHD) diseases and myocardial infarction (MI) by ELISA and biosensor techniques to achieve the improved sensitivity of the biosensor. It was found that cTnI levels in healthy subjects ranged from 8-13 ng/dl and in patients with IHD ranged from 20 - 41 ng/dl and MI range from 57- 180 ng/dl. The sensitivity of biosensor was ranged from 85-95% compared with ELISA technique. The developed biosensor is promising in ICU hospitals for early diagnosis and prevent complications of the stroke. It is recommended to apply this biosensor in the large scale of patients with different stages of the cardiac disease.

scholarly journals Diabetic Ketoacidosis and Related Events With Sotagliflozin Added to Insulin in Adults With Type 1 Diabetes: A Pooled Analysis of the inTandem 1 and 2 Studies

2020 ◽  
Author(s):  
Anne L. Peters ◽  
Darren K. McGuire ◽  
Thomas Danne ◽  
Jake A. Kushner ◽  
Helena W. Rodbard ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Ketoacidosis ◽  
Risk Mitigation ◽  
Pooled Analysis ◽  
Once Daily ◽  
Adjusted Incidence Rate ◽  
Beta Hydroxybutyrate ◽  
Design And Methods ◽  
Adjusted Incidence

<b>Objective: </b>To evaluate incidence and risk factors for diabetic ketoacidosis (DKA) and related adverse events (AEs) in adults with type 1 diabetes treated with sotagliflozin adjunctive to insulin. <p><b>Research Design and Methods: </b>Data from two identically designed, 52-week, randomized studies were pooled and analyzed for DKA, changes in beta-hydroxybutyrate (BHB), and percentage of patients with BHB >0.6 and >1.5 mmol/L; patients were administered placebo, sotagliflozin 200 mg, or sotagliflozin 400 mg once daily. </p> <p><b>Results:</b> A total of 191 ketosis-related AEs were reported; 98 underwent adjudication. Of these, 37 (36 patients) were adjudicated as DKA, with an exposure-adjusted incidence rate of 0.2, 3.1, and 4.2 events per 100 patient-years for placebo, sotagliflozin 200 mg, and sotagliflozin 400 mg. No patient died from a DKA event. From a baseline BHB of ~0.13 mmol/L, sotagliflozin treatment led to a small median increase over 52 weeks (≤0.05 mmol/L at all time points). Approximately 47% and 7% of sotagliflozin-treated patients had ≥1 BHB measurement >0.6 mmol/L and >1.5 mmol/L (vs 20% and 2% of placebo-treated patients). Subsequent to the implementation of a risk mitigation plan, annualized DKA incidence was lower versus pre-implementation in both the sotagliflozin 200-mg and 400-mg groups. </p> <p><b>Conclusion:</b> In patients with type 1 diabetes, confirmed DKA incidence increased when sotagliflozin was added to insulin compared with insulin alone. A lower incidence of DKA was observed following the implementation of an enhanced risk mitigation plan, suggesting that this risk can be managed with patient education.</p>

Measurements of cardiac troponin I and creatine kinase myocardium isoform in dogs with diabetic ketoacidosis

2016 ◽  
Vol 25 (6) ◽  
pp. 1185-1191 ◽  
Author(s):  
Sirilak Disatian Surachetpong ◽  
Pleansaung Vichit ◽  
Vachira Hunprasit
Keyword(s):  
Creatine Kinase ◽  
Diabetic Ketoacidosis ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Cardiac Troponin I

scholarly journals Type 1 and 2 Myocardial Infarction and Myocardial Injury: Clinical Transition to High-Sensitivity Cardiac Troponin I

2017 ◽  
Vol 130 (12) ◽  
pp. 1431-1439.e4 ◽  
Author(s):  
Yader Sandoval ◽  
Stephen W. Smith ◽  
Anne Sexter ◽  
Sarah E. Thordsen ◽  
Charles A. Bruen ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Troponin ◽  
Myocardial Injury ◽  
Troponin I ◽  
High Sensitivity ◽  
Cardiac Troponin I ◽  
Clinical Transition

scholarly journals The impact of age on the diagnosis of type 1 myocardial infarction using high-sensitivity cardiac troponin

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
M T H Lowry ◽  
D Doudesis ◽  
D Kimenai ◽  
A Anand ◽  
N L Mills
Keyword(s):  
Myocardial Infarction ◽  
Diagnostic Accuracy ◽  
Cardiac Troponin ◽  
Older Patients ◽  
Troponin I ◽  
Age Groups ◽  
High Sensitivity ◽  
Cardiac Troponin I ◽  
Cardiovascular Comorbidities

Abstract Background Cardiac troponin concentrations are influenced by age and comorbidities with values above the 99th centile diagnostic threshold more common in older patients without myocardial infarction. Despite this, rule-in thresholds for myocardial infarction are applied universally regardless of age or comorbidities. Purpose We sought to evaluate how age and cardiovascular comorbidities influence the diagnostic performance of high-sensitivity cardiac troponin I for myocardial infarction. Methods In a secondary analysis of a multi-centre randomised controlled trial, we identified 45,991 consecutive patients with suspected acute coronary syndrome without ST-segment elevation myocardial infarction. The diagnostic performance of high-sensitivity cardiac troponin I measured at presentation for type 1 myocardial infarction was evaluated for the sex-specific 99th centile and thresholds three and five times this value in patients stratified by age (under 50 years, between 50 and 75 years, and over 75 years). The effect of comorbidities on diagnostic accuracy was evaluated using regression modelling. Results Of the 45,991 patients, 8,187 (18%) had myocardial injury of which 7,677 (94%) had a presentation troponin above the sex-specific 99th centile. Mean age of those with myocardial injury was 74 years (range 18–108). The positive predictive value (PPV) of the 99th centile was 54.6% (95% confidence interval [CI] 50.6–58.8%), 58.8% (56.9–60.6%) and 36.6% (35.1–38.2%) in patients under 50 years, between 50 and 75 years, and over 75 years, respectively. Rule-in thresholds three and five-times the 99th centile gave a higher PPV in all age groups with a PPV of 45.5% (43.1–47.8%) and 50.4% (47.6–53.2%), respectively in those aged over 75 years (Table 1). Regardless of threshold, specificity and PPV was lowest in patients over 75 years and decreased with advancing age (Figure 1). Across all age groups, the presence of heart failure resulted in the greatest decrease in PPV (36.9% [34.6–39.2%] versus 50.6% [49.3–51.8%]). Adjusting for cardiovascular comorbidities resulted in modest change in the discrimination of cardiac troponin for myocardial infarction (area under curve 0.89 vs 0.90) and did not prevent a decline in diagnostic accuracy in older patients. Conclusion The specificity and PPV of high-sensitivity cardiac troponin I for myocardial infarction decreases with advancing age. Cardiovascular comorbidities impact the PPV of troponin, but do not explain the decline in diagnostic accuracy with age. Clinicians should be aware of these important differences in performance by age of the diagnostic and rule-in thresholds for myocardial infarction when interpreting troponin results in older patients. FUNDunding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): University of Edinburgh Figure 1

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