Insulin-induced hypoglycaemia and the detection of myocardial injury using an ultrasensitive troponin assay

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Quah, Jing
Carlton, Edward
Rana, Omar
Byrne, Christopher D
Senior, Roxy
Anstey, Chris
Greaves, Kim
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2016
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Abstract

Hypoglycaemia is associated with increased cardiovascular and all-cause mortality in both subjects with and without coronary artery disease (CAD) [1]. Our group recently demonstrated that insulin-induced hypoglycaemia (IIH) is associated with a 14% reduction of myocardial blood flow reserve (MBFR) compared to baseline, in both healthy subjects and those with type 1 diabetes mellitus (T1DM) [2]. Cardiac troponin is a sensitive marker of myocardial injury and higher levels have been linked to adverse outcomes in patients with ACS [3]. A new ultrasensitive cardiac troponin I (us-cTnI) has been developed which has a limit of detection of at least one order of magnitude lower below that of current commercial assays. In comparison with current generation troponin assays, us-cTnI has been shown to be more sensitive in the detection of myocardial ischaemia. Furthermore, low but elevated levels of us-cTnI in patients presenting with suspected ACS, have been linked to adverse cardiovascular outcomes and death [4]. This study investigated whether 60 min duration of symptomatic IIH and reduction in MBFR, was associated with myocardial injury as determined by a change in serum levels of us-cTnI measured immediately following hypoglycaemia, in healthy and diabetic subjects without obstructive CAD.

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International Journal of Cardiology

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215

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© 2016 Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence (http://creativecommons.org/licenses/by-nc-nd/4.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly cited.

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Cardiovascular medicine and haematology

Science & Technology

Life Sciences & Biomedicine

Cardiac & Cardiovascular Systems

Cardiovascular System & Cardiology

Hypoglycaemia

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Quah, J; Carlton, E; Rana, O; Byrne, CD; Senior, R; Anstey, C; Greaves, K, Insulin-induced hypoglycaemia and the detection of myocardial injury using an ultrasensitive troponin assay, International Journal of Cardiology, 2016, 215, pp. 446-448

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