Urinary Tract Infection as an Independent Predictor of Myocardial Injury in Patients with Diabetes Mellitus A Laboratory-Based Cardiovascular Study
DOI:
https://doi.org/10.64105/hjc4g765Keywords:
Diabetes Mellitus, Urinary Tract Infection, Myocardial Injury, Hs-Troponin, B-Type Natriuretic Peptide, Cardiovascular Risk.Abstract
Background: Diabetes mellitus makes people more vulnerable to infections and subclinical cardiac damage, however it is yet unknown whether UTIs may cause myocardial damage on their own in diabetic individuals.
Objective: To evaluate urinary tract infection as an independent predictor of myocardial injury in patients with diabetes mellitus through laboratory-based cardiovascular assessment.
Methodology: This prospective observational analytical study was conducted from January 2023 to June 2024. A total of 210 adult patients with confirmed diabetes mellitus were enrolled and categorized into those with UTI (n = 108; 51.43%) and without UTI (n = 102; 48.57%). Demographic and clinical data were collected, and laboratory investigations included urine culture, fasting blood glucose, HbA1c, high-sensitivity cardiac troponin (hs-Tn), and B-type natriuretic peptide (BNP). Laboratory-defined myocardial injury was considered present if hs-Tn was elevated above the reference limit. Comparative analysis was performed using t-tests and chi-square tests, and multivariate logistic regression was applied to identify independent predictors of myocardial injury.
Results: Mean age was comparable between groups (57.2 ± 9.6 vs 55.6 ± 10.0 years; p = 0.214), while females were more frequent in the UTI group (60/108; 55.56% vs 38/102; 37.25%; p = 0.009). Patients with UTI had higher HbA1c (8.8 ± 1.3 vs 8.0 ± 1.1; p < 0.001) and hypertension prevalence (72/108; 66.67% vs 52/102; 50.98%; p = 0.021). Elevated hs-Tn and BNP were more common in the UTI group (hs-Tn: 39/108, 36.11% vs 14/102, 13.73%; BNP: 34/108, 31.48% vs 16/102, 15.69%). Laboratory-defined myocardial injury occurred in 53/210 patients (25.23%), more frequently in the UTI group (38/108; 35.19%) compared to the non-UTI group (15/102; 14.71%; p < 0.001). Multivariate analysis confirmed UTI (adjusted OR = 2.84; 95% CI: 1.45–5.57; p = 0.002) and HbA1c ≥8% (adjusted OR = 2.31; 95% CI: 1.14–4.68; p = 0.019) as independent predictors of myocardial injury.
Conclusion: Urinary tract infection is an independent predictor of laboratory-defined myocardial injury in patients with diabetes mellitus.
