In patients with diabetes mellitus (DM), incident cardiovascular (CV) events are associated with poor long-term outcomes. Serum high-sensitivity troponin I (hs-TnI) is widely used to diagnose and predict outcomes in patients with acute coronary syndrome, however, few studies have investigated the accuracy of urine hs-TnI as a predictor for incident CV events in patients with DM. The enrolled participants included patients with DM. Fresh urine hs-TnI levels were measured. Medical records of enrolled patients were used to determine the number of incident CV events prospectively for 3 months. The study cohort comprised 378 participants. We observed significantly higher levels of urine hs-TnI in those with than without subsequent incident CV events. The multivariate logistic regression analysis using different models consistently showed that urine hs-TnI > 4.10 pg/mL was an independent factor predictive of incident CV events. The ROC-AUC analysis revealed that the optimal cutoff value for urine hs-TnI for predicting incident CV events was 1.55 pg/mL and the area was 0.611 (p = 0.027). A single measurement of urinary hs-TnI, collected easily and non-invasively, may be an acceptable biomarker for predicting subsequent incident CV events in patients with DM.
This study proposes the prototype of a wrist pulse acquisition device with three-dimensional pulse image (3DPI) obtained at the radial artery. The proposed prototype is designed with mechanical and electronic circuit hardware as well as the control and data acquisition software to have fourteen degrees of movement freedom against the sophisticated geometry of the wrist radial artery for accurate pulse-taking. Three robot fingers with nine degrees of movement freedom and a wrist fixer with two degrees of rotation freedom and one degree of manual movement freedom are designed to mimic the fine pulse-taking skill of a Chinese medicine physician. The customer-designed array sensors with 5 × 5-1 sensing elements in an array are attached on the robot fingertips to get 3DPI with spatial information for direct translation of pulse feeling patterns in Chinese medicine texts, in addition to being compatible with 1D pulse wave analysis. To check reliability of the prototype, adopted is SphygmoCor with pulse data correlation. Consequently, the prototype passes safety tests and has high correlation of pulse data (waveform and peripheral augmented index) with those obtained by SphygmoCor. The automatic multi-depth pulse-taking with robot fingers attached array sensors on their tips can get acceptably repeatable pulse data with coefficient of variation less than 10%. By simultaneous pulse-taking at Cun-Guan-Chi positions, 3DPIs demonstrate great different stereoscopic waveshapes against almost unchanged single temporal pulse waveshape. Hence, the proposed prototype may be a useful tool to perform array pulse-taking for Chinese medicine pulse diagnosis and pulse wave analysis for cardiovascular examination.INDEX TERMS Radial pulse measurements, three-dimensional pulse image (3DPI), pulse wave analysis (PWA), Chinese medicine (CM), medical instrumentation, biomedical engineering.
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