ABSTRACT
AIM: The objective of this work was to define a value for the 99th percentile of high-sensitive troponin T and to evaluate the prognostic value of this biomarker in a population of patients with type 2 diabetes without a history of cardiovascular disease. METHODS: In this prospective, observational and analytic study, 482 patients with type 2 diabetes were enrolled. The patients were asymptomatic, with no history of cardiovascular events, renal insufficiency, or inflammatory or systemic disease. As events we considered a combined end point of major adverse cardiovascular events (MACE). RESULTS: 94.9% of the patients had detectable troponin values, 20.7% of the patients had troponin values above the healthy population reference upper threshold (14pg/mL). The 99th percentile value for this patient population was 48pg/mL. Age, sex, the glomerular filtration rate and hypertension were associated with troponin values>14pg/mL. The incidence of MACE was 3.96 per 100 patients/year (p/y) between those with hs-TnT>14pg/mL and 1.07 per 100 p/y between those with hs-TnT≤14pg/mL (HR=3.78 CI95 1.49-9.58; p=0.005). CONCLUSIONS: The 99th percentile value of troponin T in a population of patients with type 2 diabetes is 3-fold higher than the value proposed by the manufacturer for a healthy population. We also observed a significant difference in the distribution of troponin T values between men and women. This biomarker may be a valuable prognostic factor, since troponin T values above the reference upper threshold were associated with an increase in the risk of cardiovascular events in these patients.
Subject(s)
Diabetes Mellitus, Type 2 , Troponin T/blood , Biomarkers/blood , Cardiovascular Diseases/diagnosis , Diabetes Mellitus, Type 2/blood , Female , Humans , Male , Prognosis , Prospective StudiesABSTRACT
AIM: The objective of this work was to define a value for the 99th percentile of high-sensitive troponin T and to evaluate the prognostic value of this biomarker in a population of patients with type 2 diabetes without a history of cardiovascular disease. METHODS: In this prospective, observational and analytic study, 482 patients with type 2 diabetes were enrolled. The patients were asymptomatic, with no history of cardiovascular events, renal insufficiency, or inflammatory or systemic disease. As events we considered a combined end point of major adverse cardiovascular events (MACE). RESULTS: 94.9% of the patients had detectable troponin values, 20.7% of the patients had troponin values above the healthy population reference upper threshold (14pg/mL). The 99th percentile value for this patient population was 48pg/mL. Age, sex, the glomerular filtration rate and hypertension were associated with troponin values>14pg/mL. The incidence of MACE was 3.96 per 100 patients/year (p/y) between those with hs-TnT>14pg/mL and 1.07 per 100 p/y between those with hs-TnT≤14pg/mL (HR=3.78 CI95 1.49-9.58; p=0.005). CONCLUSIONS: The 99th percentile value of troponin T in a population of patients with type 2 diabetes is 3-fold higher than the value proposed by the manufacturer for a healthy population. We also observed a significant difference in the distribution of troponin T values between men and women. This biomarker may be a valuable prognostic factor, since troponin T values above the reference upper threshold were associated with an increase in the risk of cardiovascular events in these patients.
ABSTRACT
Introducción. El jefe de residentes es una figura estratégica en el liderazgo y cohesión entre los residentes.Objetivo. Caracterizar actividades desarrolladas por jefes de residentes e identificar logros y dificultades.Métodos. Se realizó una encuesta; sobre variables demográficas, actividades desarrolladas, situaciones más y menos gratificantes, necesidad de capacitación.Resultados. Contestaron el 88 % de los jefes de residentes; el 46 % fueron mujeres. Las actividades fueron asistenciales (el 26 %), gestión académica (el 25 %), docentes (el 24 %), administrativas (el 16 %) e investigación (el 10 %).La situación más gratificante fue el desarrollo del rol docente, y la menos gratificante, las dificultades en el manejo de relaciones interpersonales. El 57 % reconoció la falta de capacitación, y el 95 % recomendaría realizar la jefatura de residentes.Conclusión. La situación más gratificante fue el desarrollo del rol docente, y la menos gratificante, las dificultades en el manejo de relaciones interpersonales
Introduction. The chief resident plays a strategic role in terms of leadership and cohesion among residents.Objective. To characterize the activities developed by chief residents and identify their achievements and difficulties.Methods. A survey about demographic outcome measures, activities performed, most and least gratifying situations, and training needs was completed.Results. In total, 88 % of chief residents completed the survey; 46 % were females. Activities were related to health care (26 %), academic management (25 %), teaching (24 %), administration (16 %), and research (10 %). The most gratifying situation was playing a teaching role, and the least gratifying one were difficulties in the management of interpersonal relations. A lack of training was recognized by 57 %, whereas 95 % would recommend becoming a chief resident.Conclusion. The most gratifying situation was playing a teaching role, and the least gratifying one were difficulties in the management of interpersonal relations
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Teaching , Hospitals, Teaching , Leadership , Role , Surveys and Questionnaires , Education, Graduate , Faculty , Internship and ResidencyABSTRACT
INTRODUCTION: The chief resident plays a strategic role in terms of leadership and cohesion among residents. OBJECTIVE: To characterize the activities developed by chief residents and identify their achievements and difficulties. METHODS: A survey about demographic outcome measures, activities performed, most and least gratifying situations, and training needs was completed. RESULTS: In total, 88 % of chief residents completed the survey; 46 % were females. Activities were related to health care (26 %), academic management (25 %), teaching (24 %), administration (16 %), and research (10 %). The most gratifying situation was playing a teaching role, and the least gratifying one were difficulties in the management of interpersonal relations. A lack of training was recognized by 57 %, whereas 95 % would recommend becoming a chief resident. CONCLUSION: The most gratifying situation was playing a teaching role, and the least gratifying one were difficulties in the management of interpersonal relations.
Introducción. El jefe de residentes es una figura estratégica en el liderazgo y cohesión entre los residentes. Objetivo. Caracterizar actividades desarrolladas por jefes de residentes e identificar logros y dificultades. Métodos. Se realizó una encuesta; sobre variables demográficas, actividades desarrolladas, situaciones más y menos gratificantes, necesidad de capacitación. Resultados. Contestaron el 88 % de los jefes de residentes; el 46 % fueron mujeres. Las actividades fueron asistenciales (el 26 %), gestión académica (el 25 %), docentes (el 24 %), administrativas (el 16 %) e investigación (el 10 %). La situación más gratificante fue el desarrollo del rol docente, y la menos gratificante, las dificultades en el manejo de relaciones interpersonales. El 57 % reconoció la falta de capacitación, y el 95 % recomendaría realizar la jefatura de residentes. Conclusión. La situación más gratificante fue el desarrollo del rol docente, y la menos gratificante, las dificultades en el manejo de relaciones interpersonales.