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Relationship between hemoglobin A1c and serum troponin in patients with diabetes and cardiovascular events

  • Review article
  • Published:
Journal of Diabetes & Metabolic Disorders Aims and scope Submit manuscript

Abstract

Objectives

Diabetes mellitus is a group of metabolic disorders associated with high risk for cardiovascular disease. Although troponins are primarily clinically used for the diagnosis of acute coronary syndrome, they are also used in risk assessment in patients with acute coronary syndrome as well as in a number of other conditions. The aim of this review was to investigate the relationship between hemoglobin A1c and serum troponin in patients with diabetes and cardiovascular events.

Methods

Hemoglobin A1c has been chosen as the best clinical indicator of glucose control and risk of micro and macrovascular complications. We investigated cardiac troponins as a group of markers of muscle injury which includes troponin T, troponin I and troponin C. Troponin T and I are specific for myocardial injury, compared to C which is specific for skeletal muscle.

Results

In this review, we showed that there was a causal relation between hemoglobin A1c levels and serum troponin concentrations. Hemoglobin A1c has shown to be a positive predictive factor of incidence, mortality and morbidity of conditions such as acute coronary syndrome, arrhythmias, stroke, pulmonary embolism and other conditions that causes troponin elevation by its release in circulation.

Conclusions

Chronic hyperglycemia decreases glomerular filtration and consequently decreases troponin elimination and also by affecting the heart microcirculation it leads to microvascular damage and consequently to ischemia which contribute to troponin concentration elevation. Furthermore, correlation between hemoglobin A1c and troponin concentration manifests in their prognostic value for mortality.

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Authors and Affiliations

  1. School of Medicine, University of Zagreb, Šalata 3, 10000, Zagreb, Croatia

    Stjepan Šimić, Tomo Svaguša, Ingrid Prkačin & Tomislav Bulum

  2. Department of Internal Medicine, Dubrava University Hospital, Zagreb, Croatia

    Tomo Svaguša

  3. Department of Internal Medicine, Merkur University Hospital, Zagreb, Croatia

    Ingrid Prkačin

  4. Vuk Vrhovac Clinic for Diabetes, Endocrinology and Metabolic Diseases, Merkur University Hospital, Zagreb, Croatia

    Tomislav Bulum

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Šimić, S., Svaguša, T., Prkačin, I. et al. Relationship between hemoglobin A1c and serum troponin in patients with diabetes and cardiovascular events. J Diabetes Metab Disord 18, 693–704 (2019). https://doi.org/10.1007/s40200-019-00460-9

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