Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access
Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc
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Original Article

Volume 8, Number 6, December 2017, pages 304-311


Association of Hemorheology With High-Sensitivity Cardiac Troponin T Levels in Patients With Type 2 Diabetes Mellitus Assessed by Microchannel Array Flow Analyzer

Figures

Figure 1.
Figure 1. System of microchannel array flow analyzer. The microchannel passage time of 100 µL of physiologic saline was measured as a control, and then that of venous whole blood obtained from the subjects with 5% heparinization was determined. The whole blood passage time of the subjects was expressed after correction for the passage time of physiologic saline. Inter- and intra-assay coefficients of variation for whole blood passage time were 8% and 5%, respectively.
Figure 2.
Figure 2. Relationship between hs-cTnT and WBPT. There is significantly positive correlations between log-hs-cTnT and WBPT (r = 0.40, P < 0.001). hs-cTnT: high sensitivity cardiac troponin T; WBPT: whole blood passage time.
Figure 3.
Figure 3. Results of multiple logistic regression analysis for high hs-cTnT. Patients with high (≥ 70 s; odds ratio, 5.3 (95% CI, 1.6 - 16.1); P < 0.01) and median (50.2 - 69.8 s; odds ratio, 3.8 (95% CI, 1.2 - 12.4); P < 0.05) WBPT had a significantly higher risk for high hs-cTnT levels (≥ 0.014 ng/mL) than those with low WBPT (≤ 50.0 s). Adjustment factors: CAVI, log-BNP, skin AF, d-ROMs test, age. *P < 0.05 vs. ≤ 50.0 s, **P < 0.01 vs. ≤ 50.0 s. CI: confidence interval; CAVI: cardio-ankle vascular index; BNP: brain natriuretic peptide; AF: autofluorescence; d-ROMs: derivatives of reactive oxygen metabolites.

Tables

Table 1. Patient Characteristics
 
Overallhs-cTnT non-detectionhs-cTnT detectionP value
Data are expressed as mean ± standard deviation. hs-cTnT: high-sensitivity cardiac troponin T; BP: blood pressure; LDL: low-density lipoprotein; HDL: high-density lipoprotein; FBG: fasting blood glucose; IRI: immunoreactive insulin; HOMA-IR: homeostatic model assessment of insulin resistance; AF: autofluorescence; eGFR: estimated glomerular filtration rate; BNP: brain natriuretic peptide; d-ROMs: derivatives of reactive oxygen metabolites; CAVI: cardio-ankle vascular index; WBPT: whole blood passage time; DPP: dipeptidyl peptidase; RAS: renin-angiotensin system.
n (male/female)301 (116/185)40 (18/22)261 (98/163)0.369
Age (years)65 ± 1161 ± 1066 ± 12< 0.01
Body mass index (kg/m2)23 ± 421 ± 324 ± 4< 0.01
Current smoker, n (%)70 (23)6 (15)64 (24)0.206
Hypertension, n (%)211 (70)28 (70)183 (70)0.920
Systolic BP (mm Hg)140 ± 20136 ± 15140 ± 200.053
Diastolic BP (mm Hg)87 ± 1384 ± 1188 ± 130.059
Dyslipidemia (%)178 (59)23 (58)155 (59)0.874
Total cholesterol (mg/dL)219 ± 41216 ± 40219 ± 410.433
LDL cholesterol (mg/dL)140 ± 38137 ± 37140 ± 380.559
Triglyceride (mg/dL)146 ± 70142 ± 83146 ± 690.485
HDL cholesterol (mg/dL)50 ± 1651 ± 1550 ± 160.890
FBG (mg/dL)133 ± 27123 ± 28134 ± 27< 0.05
IRI (µg/mL)7.8 ± 4.86.7 ± 4.98.0 ± 4.80.068
HOMA-IR2.6 ± 1.02.1 ± 1.62.6 ± 1.60.052
Hemoglobin A1c (%)7.1 ± 1.06.8 ± 0.97.1 ± 1.0< 0.05
SkinAF (AU)2.7 ± 0.62.0 ± 0.42.8 ± 0.7< 0.001
White blood cell (/µL)5,371 ± 1,5874,965 ± 1,0865,433 ± 1,6430.082
Hematocrit (%)42.6 ± 4.942.5 ± 5.242.6 ± 4.80.853
Platelet (104/µL)23.1 ± 5.521.8 ± 6.923.3 ± 5.30.119
eGFR (mL/min/1.73 m2)67 ± 2073 ± 1966 ± 21< 0.05
Cornell voltage (mm)15 ± 513 ± 415 ± 5< 0.05
Log-BNP (pg/mL)1.7 ± 0.41.4 ± 0.41.8 ± 0.3< 0.001
d-ROMs test (U. Carr)336 ± 108259 ± 82348 ± 107< 0.001
CAVI9.2 ± 1.58.6 ± 1.39.4 ± 1.5< 0.001
WBPT (s)63 ± 1850 ± 1364 ± 18< 0.001
Log-hs-cTnT (ng/mL)-1.9 ± 0.2--1.9 ± 0.2-
Medication
  Sulfonylurea, n (%)217 (72)29 (73)188 (72)0.951
  Metformin, n (%)84 (28)12 (29)72 (28)0.903
  DPP-4 inhibitor, n (%)160 (53)20 (50)140 (54)0.669
  Insulin, n (%)18 (6)3 (8)15 (6)0.887
  RAS inhibitor, n (%)175 (58)20 (50)155 (59)0.157
  Statin, n (%)138 (46)16 (40)122 (47)0.276

 

Table 2. Correlation Between Hs-cTnT, WBPT and Clinical Parameters in Hs-cTnT Detectable Patients
 
r
Log-hs-cTnTWBPT
r expressed correlation coefficient. *P < 0.05, **P < 0.01, ***P < 0.001. hs-cTnT: high-sensitivity cardiac troponin T; BP: blood pressure; LDL: low-density lipoprotein; HDL: high-density lipoprotein; FBG: fasting blood glucose; IRI: immunoreactive insulin; HOMA-IR: homeostatic model assessment of insulin resistance; AF: autofluorescence; eGFR: estimated glomerular filtration rate; BNP: brain natriuretic peptide; d-ROMs: derivatives of reactive oxygen metabolites; CAVI: cardio-ankle vascular index; WBPT: whole blood passage time; DPP: dipeptidyl peptidase; RAS: renin-angiotensin system.
Sex (female = 0, male = 1)0.040.06
Age0.19**0.03
Body mass index0.14*0.18**
Current smoker (no = 0, yes = 1)0.070.20**
Hypertension (no = 0, yes = 1)0.12*0.13*
Systolic BP0.080.10
Diastolic BP0.060.08
Dyslipidemia (no = 0, yes = 1)-0.03-0.01
Total cholesterol-0.040.08
LDL cholesterol-0.050.07
Triglyceride-0.030.21**
HDL cholesterol-0.07-0.09
FBG0.070.11
IRI0.050.07
HOMA-IR0.060.10
Hemoglobin A1c0.13*0.13*
Skin AF0.32***0.36***
White blood cell0.060.13*
Hematocrit0.050.20**
Platelet0.030.08
eGFR-0.19**-0.14*
Cornell voltage0.22***0.10
Log-BNP0.35***0.07
d-ROMs test0.30***0.40***
CAVI0.41***0.42***
Sulfonylurea (no = 0, yes = 1)-0.05-0.08
Metformin (no = 0, yes = 1)-0.03-0.03
DPP-4 inhibitor (no = 0, yes = 1)-0.05-0.06
Insulin (no = 0, yes = 1)-0.05-0.06
RAS inhibitor (no = 0, yes = 1)-0.09-0.07
Statin (no = 0, yes = 1)-0.07-0.09

 

Table 3. Multiple Regression Analysis
 
Explanatory factorβP value
(A) Subordinate factor is hs-cTnT R2 = 0.3. (B) Subordinate factor is WBPT R2 = 0.44. CAVI: cardio-ankle vascular index; WBPT: whole blood passage time; BNP: brain natriuretic peptide; AF: autofluorescence; d-ROMs: derivatives of reactive oxygen metabolite; eGFR: estimated glomerular filtration rate; hs-cTnT: high-sensitivity cardiac troponin T.
(A)
  CAVI0.27< 0.001
  WBPT0.24< 0.001
  Log-BNP0.21< 0.01
  Skin AF0.20< 0.01
  d-ROMs test0.19< 0.05
  Age0.18< 0.05
  Cornell voltage0.090.104
  eGFR-0.060.251
(B)
  Skin AF0.36< 0.001
  Log-hs-cTnT0.29< 0.001
  d-ROMs test0.19< 0.01
  CAVI0.15< 0.05
  Hematocrit0.13< 0.05
  Current smoker0.12< 0.05
  Triglyceride0.040.387