Chronic hyperglycemia and subclinical myocardial injury

Jonathan Rubin, Kunihiro Matsushita, Christie M. Ballantyne, Ron Hoogeveen, Josef Coresh, Elizabeth Selvin

Research output: Contribution to journalArticlepeer-review

86 Scopus citations


Objectives: The purpose of this study was to examine the association between hyperglycemia and subclinical myocardial injury in persons without clinically evident coronary heart disease (CHD). Background: Hyperglycemia is associated with an increased risk of cardiac events, but limited information is available on its relationship to subclinical myocardial damage. Elevated cardiac troponin T even below traditional detection levels can be detected by a novel high-sensitivity assay. Methods: We examined the association between baseline glycated hemoglobin (HbA1c) and high-sensitivity cardiac troponin T (hs-cTnT) in 9,661 participants free of CHD and heart failure in the ARIC (Atherosclerosis Risk in Communities) study. Multivariable logistic regression models characterized the association between clinical categories of HbA1c (<5.7%, 5.7% to 6.4%, and <6.5%) and our primary outcome of elevated hs-cTnT (<14 ng/l). Results: Higher baseline values of HbA1c were associated in a graded fashion with elevated hs-cTnT (p for trend < 0.001). After adjusting for traditional risk factors, compared to persons with HbA1c <5.7%, the odds ratios of elevated hs-cTnT for persons with HbA1c 5.7% to 6.4% and <6.5% were 1.26 (95% confidence interval: 1.01 to 1.56) and 1.97 (95% confidence interval: 1.44 to 2.70), respectively. Conclusions: Higher HbA1c is associated with elevated hs-cTnT among persons without clinically evident CHD, suggesting that hyperglycemia contributes to myocardial injury beyond its effects on development of clinical atherosclerotic coronary disease.

Original languageEnglish (US)
Pages (from-to)484-489
Number of pages6
JournalJournal of the American College of Cardiology
Issue number5
StatePublished - Jan 31 2012


  • diabetes mellitus
  • epidemiology
  • hyperglycemia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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