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.

The urine albumin (Alb)-to-creatinine (Crn) ratio (UACR) is a sensitive and early indicator of chronic kidney disease (CKD) and cardiorenal syndrome. This study developed a portable and wireless electrochemical-sensing platform for the sensitive and accurate determination of UACR. The developed platform consists of a carbon nanotube (CNT)-2,2′-azino-bis(3-ethylbenzothiazoline-6-sulphonic acid)(ABTS)-based modified UACR sensor, a miniaturised potentiostat, a cup holder embedded with a magnetic stirrer and a smartphone app. The UACR sensing electrode is composed of two screen-printed carbon working electrodes, one screen-printed carbon counter electrode and a screen-printed AgCl reference electrode. The miniaturised potentiostat, which is controlled by the developed app, performs cyclic voltammetry and amperometry to detect Alb and Crn, respectively. Clinical trials of the proposed system by using spot urine samples from 30 diabetic patients indicate that it can accurately classify all three CKD risk statuses within 30 min. The high accuracy of our proposed sensing system exhibits satisfactory agreement with the commercial biochemical analyser TBA-25FR (Y = 0.999X, R² = 0.995). The proposed UACR sensing system offers a convenient, reliable and affordable solution for personal mobile health monitoring and point-of-care urinalysis.

Aims Emergency department (ED) visits for decompensated heart failure (HF) are frequent and associated with poor long‐term outcomes in patients with HF. Serum N‐terminal pro b‐type natriuretic peptide (NT‐proBNP) is widely used to assist diagnosis and predict clinical outcomes in HF patients. Few studies have investigated the use of urine NT‐proBNP as an HF biomarker. This study aims to assess the value of urine NT‐proBNP for predicting ED visits for decompensated HF as compared with that of serum NT‐proBNP. Methods and results This study included 122 HF patients with reduced left ventricular ejection fraction (<50%). Serum and urine NT‐proBNP levels were measured. Baseline data included demographics, comorbidities, and co‐medications. Medical records were used to determine the incidence of visits to the ED for decompensated HF during the 3 months following the last visit. We observed significantly higher levels of both serum and urine NT‐proBNP in patients with subsequent ED visits than in those without. Multivariate logistic regression analysis showed that urine NT‐proBNP/creatinine ratio (OR, 1.031; 95% CI, 1.001–1.061; P = 0.046) but not serum NT‐proBNP was an independent factor associated with subsequent ED visits. According to receiver‐operating characteristic‑area under the curve analysis, the optimal cut‐off value of urine NT‐proBNP/creatinine ratio for predicting subsequent heart‐failure related ED visits was 0.272 pg/μg Cr (area under the curve, 0.675; P = 0.011). Conclusions For HF patients with reduced left ventricular ejection fraction, a single measurement of urinary NT‐proBNP/creatinine ratio is predictive of subsequent ED visits for decompensated HF. This non‐invasive and easy measurement may be a clinically useful tool for monitoring clinical outcomes and identifying a subset of patients at higher risk of ED visits within a short time.