糖尿病患者心脏标志物的诊断和预后价值综述

Tabarak Haamid Elbo-Iswadi, H. Alsharayri, Rahaf Wardeh, A. Bashier, Fauzia Rashid, Elamin Ibrahim Abdelgadir
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引用次数: 0

摘要

导言心血管疾病是糖尿病患者(PWD)死亡的主要原因。我们旨在探讨现有文献中肌钙蛋白 T (TnT) 和血清钠尿肽 (proBNP) 作为糖尿病患者心血管疾病发病率和死亡率的筛查和预后指标的作用。方法 本文是一篇非系统性的重点文献综述,研究了与心脏生物标志物的意义相关的出版物。我们的目的是研究除 proBNP 外,心脏 TnT(cTnT)和 cTnI 对糖尿病的诊断价值,以及 cTnT 和 proBNP 对糖尿病患者和非糖尿病患者的预后价值。文献检索时间为 2022 年 12 月至 2023 年 4 月。在 PubMed 和 Google Scholar 数据库中进行检索,以确定 2001 年 1 月至 2023 年 4 月期间发表的相关文章。将所选文章输入 EndNote 20 软件,提取标题和摘要。结果 在谷歌学术上共找到 75 篇文章,此外还从 PubMed 上找到 32 篇文章。经过全面审查后,只选取了 22 篇文章,指出其中讨论了 Tn 和 proBNP 标记类型的病理生理学、诊断、预后和筛查价值。TnT 在残疾人(尤其是 T2D 患者)中的价值是健康患者的三倍。高灵敏度(hs)cTnI 或 cTnT 水平较高的人死亡风险最高。尽管如此,N-末端(NT)-proBNP 和 TnT 仍可独立预测不良预后。结论 TnT 是一个重要的早期筛查工具预后指标。hs-cTn 可通过识别高死亡风险人群来帮助老年人进行糖尿病相关的临床治疗;此外,在糖尿病患者中,NT-pro-BNP 对心衰诊断的敏感性和特异性分别为 92% 和 90%。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Review of the Diagnostic and Prognostic Values of Cardiac Markers in Diabetes
Introduction Cardiovascular disease is a leading cause of mortality in people with diabetes (PWD). We aimed to explore the role of troponin T (TnT) and probrain natriuretic peptide (proBNP) as screening and prognostic indicators of cardiovascular morbidity and mortality in PWD in the existing literature. Methods This review paper is a focused narrative nonsystematic review of the literature which examined relevant publications pertinent to the significance of cardiac biomarkers. We aimed to investigate the diagnostic value of cardiac TnT (cTnT) and cTnI in addition to proBNP in diabetes and the prognostic value of cTnT and proBNP in diabetic and nondiabetic patients. The process of searching through literature was conducted from December 2022 to April 2023. Searches were done across PubMed and Google Scholar databases to identify relevant articles published from January 2001 to April 2023. The selected were entered into EndNote 20 software to extract the title and abstract. Results A total of 75 articles were identified in Google Scholar in addition to 32 articles from PubMed. After a thorough review, only a total of 22 articles were selected, pointing out those which discussed the pathophysiology and diagnostic, prognostic, and screening values of the types of Tn and proBNP markers. The value of TnT in PWD, specifically T2D, is threefold higher than in healthy patients. Individuals with high levels of high-sensitivity (hs) cTnI or cTnT were at the highest mortality risk. Nonetheless, N-terminal (NT)-proBNP and TnT function independently as predictors of unfavorable outcomes. Conclusions TnT is an important early screening tool prognostic indicator. Elevated TnT was associated with an increased risk of cardiovascular events in PWD. hs-cTn may help diabetes-related clinical care for older persons by identifying those at high mortality risk; furthermore, in diabetic individuals, NT-pro-BNP appears to be 92% sensitive and 90% specific for the diagnosis of heart failure.
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