Prognostic value of elevated postoperative high-sensitivity troponin T in diabetes mellitus patients for ischemic events within 12 months after PCI in ACS patients: a retrospective cohort study.

OBJECTIVE

This study aimed to investigate the prognostic value of high-sensitivity cardiac troponin T (hs-cTnT) levels and diabetes mellitus (DM) on ischemic events within 12 months after percutaneous coronary intervention (PCI) in acute coronary syndrome(ACS) patients.

METHODS

This retrospective cohort study included 14,173 consecutive ACS patients undergoing PCI at the General Hospital of the Northern Theater Command between March 2016 and March 2022. The primary outcome was the occurrence of ischemic events within 12 months, defined as a composite of cardiac death, non-fatal myocardial infarction (MI), and/or stroke. Secondary outcomes included all-cause mortality at 12 months and the individual components of the primary outcome.

RESULTS

During the 12-month follow-up, the overall incidence rates of ischemic events, cardiac death, MI, stroke, and all-cause mortality were 2.19%, 1.12%, 0.58%, 0.59%, and 1.55%, respectively. Elevated hs-cTnT levels were significantly associated with increased risks of ischemic events (adjusted HR: 1.91, 95% CI: 1.19-3.09), cardiac death (adjusted HR: 2.00, 95% CI: 1.08-3.71), and all-cause mortality (adjusted HR: 2.78, 95% CI: 1.62-4.76). In diabetic patients, the risks were particularly pronounced when hs-cTnT levels reached ≥5 × URL. Interaction analyses showed no significant interaction between hs-cTnT levels and diabetes status regarding ischemic events ( = 0.78), but a significant interaction for all-cause mortality ( = 0.01).

CONCLUSIONS

Elevated hs-cTnT levels and the presence of DM are independently associated with an increased risks of ischemic events and all-cause mortality after PCI in ACS patients. The impact of hs-cTnT on mortality is more pronounced in diabetic patients.