Cardiac Troponin-I Status And Associated Factors In Type-2 Diabetic Patients On Antidiabetic Drugs Treatment At Jimma Medical Center, Jimma, Southwest Ethiopia

Abstract

Background: Vascular dysfunction caused by metabolic abnormalities in patients with type-2 diabetes mellitus is associated with accelerated atherosclerosis, myocardial infarction (MI), stroke, and increased risk of coronary heart disease. In spite of all these complications, there is no literature revealing the cardiac status and associated factors using cardiac troponin as a biomarker in study area and Ethiopia too. This study aimed to assess cardiac troponin-I and associated factors in type-2 diabetic patients on anti-diabetic drug treatment at Jimma Medical Center, Jimma, Southwest Ethiopia. Methods: Facility based cross-sectional study was conducted among type-2 diabetic patients on follow-up at Jimma Medical Center chronic illness clinic from August 1 to September 30/2020. Systematic sampling technique was used to select 82 study participants, and face-to-face interview was carried out using semi-structured questionnaires during data collection. Five milliliters of venous blood was drawn from each participant after overnight fasting using an aseptic technique and centrifuged at 3000 rpm for 10 minutes. Multiple logistic regression analysis and one way ANOVA were used for statistical data analysis. P-value <0.05 was considered as statistically significant. Result: The mean age of the subjects was 53.41± 13.85 years with a range of 23-85 years. The prevalence of elevated cardiac troponin-I was 25.6 % in the study population. Age greater than or equal to 60 years (AOR=13.735, 95% CI= 2.849-16.622, P= 0.013), SBP (AOR= 2.004, 95% CI=2.000-4.455, P=0.022), TC (AOR= 6.022, 95% CI= 1.225-12.961, P=0.039), LDL (AOR= 2.416, 95% CI= 1.744-3.346, P= 0.018) and TG (AOR= 2.468, 95% CI= 1.032-5.903, P= 0.048) were predictors of elevated cardiac troponin-I. Metformin drug treatment (AOR= 0.015, 95% CI= 0.001-0.435, P=0.015) was negatively associated with cardiac troponin-I. The mean value of serum cardiac troponin-I was lower in patients who were receiving metformin monotherapy as compared to patients on insulin monotherapy (11.654 ± 1.6795 vs 20.573 ± 1.8402, P<0.01), and metformin +glibenclamide (11.654 ± 1.6795 vs 21.094 ± 2.4062, P<0.01). Conclusion: About one fourth of the study participants had elevated serum cardiac troponin-I level. Older age, systolic blood pressure and dyslipidemia were positively associated with elevated cardiac troponin-I. Metformin significantly reduced serum cTnI levels as compared to insulin monotherapy and metformin + glibenclamide. Regular screening for cardiac injury using cardiac troponin-I is recommended for type-2 diabetic patients.