03150nas a2200493 4500008004100000022001400041245010400055210006900159260001300228300001200241490000700253520179600260653000902056653001502065653002302080653001502103653001502118653001102133653001502144653002202159653003102181653001602212653001102228653002002239653001802259653002502277653000902302653003002311653002402341653002402365653001802389653001502407100001702422700001702439700002102456700002102477700002902498700002302527700001802550700001802568700001802586700001702604856003502621 2004 eng d a1046-667300aInflammatory and prothrombotic markers and the progression of renal disease in elderly individuals.0 aInflammatory and prothrombotic markers and the progression of re c2004 Dec a3184-910 v153 a
Inflammatory and prothrombotic markers are elevated in individuals with mild to moderate renal disease. It was hypothesized that these markers may also be determinants of the progression of renal disease. The association of six markers-serum C-reactive protein (CRP), white blood cell (WBC) count, fibrinogen, factor VII, albumin, and hemoglobin-with subsequent elevations of creatinine and decline in estimated GFR in the Cardiovascular Health Study, a community-based cohort of elderly individuals, was analyzed. Linear regression was used to determine predictors of an annualized change in serum creatinine as the main outcome. Duration of follow-up was 7 yr for the original cohort and 4 yr for the more recently recruited black cohort. A total of 588 (12.7%) individuals had a decline in estimated GFR of at least 3 ml/min per yr per 1.73 m(2). Higher CRP (P < 0.001), WBC count (P < 0.001), fibrinogen (P < 0.001), and factor VII (P < 0.001) levels and lower albumin (P < 0.001) and hemoglobin levels (P < 0.001) were associated with a rise in creatinine, after adjusting for age. With additional adjustments for race, gender, baseline creatinine, systolic and diastolic BP, lipid levels, weight, and pack-years smoking, higher CRP, factor VII, fibrinogen, WBC count, and lower albumin and hemoglobin levels remained associated with a rise in creatinine. Similar results were found for decline in estimated GFR. The decline in GFR was greater with increasing number of inflammatory or prothrombotic markers that were above the median (below for hemoglobin and albumin). Inflammatory and prothrombotic markers are predictors for a change in kidney function in elderly individuals. Interventions that reduce inflammation might confer significant cardiovascular and renal benefits.
10aAged10aBiomarkers10aC-Reactive Protein10aCreatinine10aFactor VII10aFemale10aFibrinogen10aFollow-Up Studies10aGlomerular Filtration Rate10aHemoglobins10aHumans10aLeukocyte Count10aLinear Models10aLongitudinal Studies10aMale10aPredictive Value of Tests10aProspective Studies10aRenal Insufficiency10aSerum Albumin10aThrombosis1 aFried, Linda1 aSolomon, Cam1 aShlipak, Michael1 aSeliger, Stephen1 aStehman-Breen, Catherine1 aBleyer, Anthony, J1 aChaves, Paolo1 aFurberg, Curt1 aKuller, Lewis1 aNewman, Anne uhttps://chs-nhlbi.org/node/81302953nas a2200457 4500008004100000022001400041245010600055210006900161260001300230300001000243490000700253520169200260653002701952653000901979653001701988653001502005653001502020653001402035653001102049653000802060653001102068653002002079653002602099653001802125653002502143653000902168653001702177653003002194100002002224700002402244700002902268700002402297700002102321700001702342700001802359700002102377700002202398700002002420700002002440856003502460 2006 eng d a1079-500600aKidney function predicts the rate of bone loss in older individuals: the Cardiovascular Health Study.0 aKidney function predicts the rate of bone loss in older individu c2006 Jul a743-80 v613 aBACKGROUND: Results of cross-sectional analyses of the association of kidney function with bone mineral density (BMD) have been conflicting. We examined the association of cystatin-C, a new marker of kidney function that is unrelated to lean mass, with initial and follow-up BMD, in an ancillary study of the Cardiovascular Health Study, a population-based cohort of individuals > or = 65 years old.
METHODS: Two years after measurement of cystatin-C and other covariates, the first BMD was measured in Pittsburgh, Pennsylvania and Davis, California, by using dual energy x-ray absorptiometry. Follow-up BMD was measured in Pittsburgh 4 years later. Associations of cystatin-C with initial BMD and the change in BMD (%/y) at the hip were examined with linear regression. Analyses were conducted separately for men and women.
RESULTS: In 1519 participants who had cystatin-C and initial BMD assessed, 614 had follow-up BMD. The percent annual change in BMD at the total hip by cystatin-C quartiles was -0.24, -0.13, -0.40, and -0.66%/y (first to fourth quartile) in women and -0.02, -0.30, -0.18, and -0.94%/y in men. After adjusting for potential confounders, cystatin-C was marginally associated with initial BMD in men but not women. Cystatin-C was associated with bone loss in men; after adjustment for weight loss, cystatin-C was not associated with bone loss in women.
CONCLUSION: Kidney dysfunction, as assessed by cystatin-C, is associated with a more rapid loss of BMD at the hip, especially in men. Further studies are needed to confirm these findings and to determine whether this loss leads to an elevated risk of fracture.
10aAbsorptiometry, Photon10aAged10aBone Density10aCreatinine10aCystatin C10aCystatins10aFemale10aHip10aHumans10aKidney Diseases10aKidney Function Tests10aLinear Models10aLongitudinal Studies10aMale10aOsteoporosis10aPredictive Value of Tests1 aFried, Linda, F1 aShlipak, Michael, G1 aStehman-Breen, Catherine1 aMittalhenkle, Anuja1 aSeliger, Stephen1 aSarnak, Mark1 aRobbins, John1 aSiscovick, David1 aHarris, Tamara, B1 aNewman, Anne, B1 aCauley, Jane, A uhttps://chs-nhlbi.org/node/90802943nas a2200457 4500008004100000022001400041245007900055210006900134260001300203300001000216490000700226520171800233653000901951653002201960653001501982653001401997653001102011653001802022653001102040653001102051653002802062653002502090653000902115653001702124653002402141653001702165653001602182100002002198700002402218700002402242700002102266700002202287700002902309700001702338700002102355700001902376700001702395700002002412700001802432856003502450 2007 eng d a1046-667300aAssociation of kidney function with incident hip fracture in older adults.0 aAssociation of kidney function with incident hip fracture in old c2007 Jan a282-60 v183 aKidney dysfunction is associated with bone loss, and patients with ESRD have an increased risk for hip fracture. However, the association of mild to moderate kidney disease with hip fracture has not been studied previously. The association of kidney function with incident hip fracture was examined among participants in the Cardiovascular Health Study, a community-based cohort of older individuals. The primary measure of kidney function was serum cystatin C, a measure that does not depend on lean mass. Hip fractures were identified using International Classification of Diseases, Ninth Revision codes for hospitalizations. A total of 4699 individuals had cystatin C measured in 1992 to 1993 and did not have a hip fracture before cystatin C measurement. The association of kidney function with hip fracture was analyzed with Cox proportional hazards models. Analyses were conducted separately for men and women. After a mean follow-up of 7.1 yr, 195 incident hip fractures occurred in women and 79 occurred in men. Higher cystatin C levels were associated with a higher risk for fracture in women (hazard ratio [HR] 1.26; 95% confidence interval [CI] 1.14 to 1.38 per SD) and in men (HR 1.27; 95% CI 1.11 to 1.46). After multivariable adjustment, higher cystatin C levels were significantly associated with hip fracture in women (HR 1.16; 95% CI 1.01, 1.33) but not in men (HR 1.14; 95% CI 0.86 to 1.52), although the magnitude of the association was similar. Kidney dysfunction, as assessed by cystatin C, is associated with an increased risk for hip fracture. Further studies are needed to evaluate potential mediators of this relationship and to assess whether interventions can decrease this risk.
10aAged10aAged, 80 and over10aCystatin C10aCystatins10aFemale10aHip Fractures10aHumans10aKidney10aKidney Failure, Chronic10aLongitudinal Studies10aMale10aOsteoporosis10aProspective Studies10aRisk Factors10aSex Factors1 aFried, Linda, F1 aBiggs, Mary, Louise1 aShlipak, Michael, G1 aSeliger, Stephen1 aKestenbaum, Bryan1 aStehman-Breen, Catherine1 aSarnak, Mark1 aSiscovick, David1 aHarris, Tamara1 aCauley, Jane1 aNewman, Anne, B1 aRobbins, John uhttps://chs-nhlbi.org/node/93302852nas a2200421 4500008004100000022001400041245009800055210006900153260001300222300001000235490000600245520167800251653000901929653002201938653002401960653002801984653002002012653002102032653002402053653001102077653001102088653001102099653002002110653000902130653002002139100002202159700002002181700002402201700002002225700002002245700001602265700002002281700002102301700002902322700002002351700002402371856003502395 2007 eng d a1555-905X00aKidney function, electrocardiographic findings, and cardiovascular events among older adults.0 aKidney function electrocardiographic findings and cardiovascular c2007 May a501-80 v23 aChronic kidney disease (CKD) is associated with cardiovascular (CV) disease and mortality. It is not known whether cardiac rhythm disturbances are more prevalent among individuals with CKD or whether resting electrocardiogram findings predict future CV events in the CKD setting. Data were obtained from the Cardiovascular Health Study, a community-based study of adults aged >/=65 yr. After exclusions for prevalent heart disease, atrial fibrillation, implantable pacemaker, or antiarrhythmic medication use, 3238 participants were analyzed. CKD was defined by an estimated GFR <60 ml/min per 1.73 m(2). Outcomes were adjudicated incident heart failure (HF), incident coronary heart disease (CHD), and mortality. Participants with CKD had longer PR and corrected QT intervals compared with those without CKD; however, differences in electrocardiographic markers were explained by traditional CV risk factors and CV medication use. After adjustment for known risk factors, each 10-ms increase in the QRS interval was associated with a 15% greater risk for incident HF (95% confidence interval [CI] 1.04 to 1.27), a 13% greater risk for CHD (95% CI 1.04 to 1.24), and a 17% greater risk for mortality (95% CI 1.09, 1.25) among CKD participants. Each 5% increase in QTI was associated with a 42% (95% CI 1.23 to 1.65), 22% (95% CI 1.07 to 1.40), and 10% (95% CI 0.98 to 1.22) greater risk for HF, CHD, and mortality, respectively. Associations seemed stronger for participants with CKD; however, no significant interactions were detected. Resting electrocardiographic abnormalities are common in CKD and independently predict future clinical CV events in this setting.
10aAged10aAged, 80 and over10aCardiac Output, Low10aCardiovascular Diseases10aChronic Disease10aCoronary Disease10aElectrocardiography10aFemale10aHumans10aKidney10aKidney Diseases10aMale10aRisk Assessment1 aKestenbaum, Bryan1 aRudser, Kyle, D1 aShlipak, Michael, G1 aFried, Linda, F1 aNewman, Anne, B1 aKatz, Ronit1 aSarnak, Mark, J1 aSeliger, Stephen1 aStehman-Breen, Catherine1 aPrineas, Ronald1 aSiscovick, David, S uhttps://chs-nhlbi.org/node/97502746nas a2200373 4500008004100000022001400041245011500055210006900170260001300239300001000252490000600262520167500268653002401943653000901967653002801976653001102004653002202015653001102037653000902048653002402057653001702081100002402098700003202122700002402154700002002178700001602198700002102214700002102235700001902256700002002275700002002295700002102315856003602336 2008 eng d a1555-905X00aCardiovascular risk factors and incident acute renal failure in older adults: the cardiovascular health study.0 aCardiovascular risk factors and incident acute renal failure in c2008 Mar a450-60 v33 aBACKGROUND AND OBJECTIVES: Although the elderly are at increased risk for acute renal failure, few prospective studies have identified risk factors for acute renal failure in the elderly.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The associations of cardiovascular disease risk factors, subclinical cardiovascular disease, and clinical coronary heart disease with the risk for development of acute renal failure were examined in older adults in the Cardiovascular Health Study, a prospective cohort study of community-dwelling older adults. Incident hospitalized cases of acute renal failure were identified through hospital discharge International Classification of Diseases, Ninth Revision codes and confirmed through physician diagnoses of acute renal failure in discharge summaries.
RESULTS: Acute renal failure developed in 225 (3.9%) of the 5731 patients during a median follow-up period of 10.2 yr. In multivariate analyses, diabetes, current smoking, hypertension, C-reactive protein, and fibrinogen were associated with acute renal failure. Prevalent coronary heart disease was associated with incident acute renal failure, and among patients without prevalent coronary heart disease, subclinical vascular disease measures were also associated with acute renal failure: Low ankle-arm index (< or =0.9), common carotid intima-media thickness, and internal carotid intima-media thickness.
CONCLUSIONS: In this large, population-based, prospective cohort study, cardiovascular risk factors and both subclinical and clinical vascular disease were associated with incident acute renal failure in the elderly.
10aAcute Kidney Injury10aAged10aCardiovascular Diseases10aFemale10aFollow-Up Studies10aHumans10aMale10aProspective Studies10aRisk Factors1 aMittalhenkle, Anuja1 aStehman-Breen, Catherine, O1 aShlipak, Michael, G1 aFried, Linda, F1 aKatz, Ronit1 aYoung, Bessie, A1 aSeliger, Stephen1 aGillen, Daniel1 aNewman, Anne, B1 aPsaty, Bruce, M1 aSiscovick, David uhttps://chs-nhlbi.org/node/101502997nas a2200409 4500008004100000022001400041245003400055210003300089260001600122300001100138490000800149520198900157653000902146653001002155653001502165653001502180653001502195653001402210653001102224653002202235653003102257653001102288653001102299653000902310100002002319700001602339700002002355700002102375700002202396700002102418700001702439700001902456700002002475700002402495710003202519856003602551 2008 eng d a0003-992600aCystatin C and aging success.0 aCystatin C and aging success c2008 Jan 28 a147-530 v1683 aBACKGROUND: To our knowledge, the effect of kidney function on successful aging has not been examined.
METHODS: We evaluated the relationship between cystatin C and aging success during a 6-year follow-up in the Cardiovascular Health Study, a community-based cohort of older adults (aged >or= 65 years). Successful aging was defined as remaining free of cardiovascular disease, cancer, and chronic obstructive pulmonary disease and having intact physical and cognitive functioning. In adjusted analysis, an accelerated failure time model was used to evaluate the percentage reduction in successful years by level of cystatin C. A separate Cox proportional hazards model evaluated whether cystatin C was related to incident physical and cognitive disability.
RESULTS: A total of 2140 participants had cystatin C measured and were free of the previously mentioned conditions at baseline. Their mean age was 74 years. The mean cystatin C level, creatinine level, and estimated glomerular filtration rate were 1.06 mg/L, 0.93 mg/dL, and 78 mL/min/1.73 m(2), respectively (to convert cystatin C to nanomoles per liter, multiply by 75; and to convert creatinine to micromoles per liter, multiply by 88.4). A total of 873 participants reached a first event in follow-up, 138 because of cognitive disability, 238 because of physical disability, 34 because of chronic obstructive pulmonary disease, 146 because of cancer, and 317 because of cardiovascular disease. The adjusted percentage reduction in successful life years in the highest vs the lowest quartile of cystatin C was 27% (95% confidence interval, 11%-39%). The highest vs lowest quartile of cystatin C also was independently associated with incident cognitive or physical disability (hazard ratio, 1.39; 95% confidence interval, 1.00-1.98).
CONCLUSION: A higher cystatin C level, even within a range of relatively normal kidney function, was associated with unsuccessful aging.
10aAged10aAging10aBiomarkers10aCreatinine10aCystatin C10aCystatins10aFemale10aFollow-Up Studies10aGlomerular Filtration Rate10aHumans10aKidney10aMale1 aSarnak, Mark, J1 aKatz, Ronit1 aFried, Linda, F1 aSiscovick, David1 aKestenbaum, Brian1 aSeliger, Stephen1 aRifkin, Dena1 aTracy, Russell1 aNewman, Anne, B1 aShlipak, Michael, G1 aCardiovascular Health Study uhttps://chs-nhlbi.org/node/101302962nas a2200421 4500008004100000022001400041245008100055210006900136260001300205300001100218490000700229520178200236653000902018653002202027653001902049653001902068653001102087653002202098653001102120653002802131653002502159653000902184653002402193653003302217653001702250653002202267100002502289700001602314700002202330700002402352700002002376700002902396700002102425700002102446700002002467700001702487856003602504 2011 eng d a1525-149700aChronic kidney disease and the risk of end-stage renal disease versus death.0 aChronic kidney disease and the risk of endstage renal disease ve c2011 Apr a379-850 v263 aBACKGROUND: Among older adults with chronic kidney disease (CKD), the comparative event rates of end-stage renal disease (ESRD) and cause-specific death are unknown.
OBJECTIVE: To compare the rates of ESRD, cardiovascular and non-cardiovascular death and examine risk factors for ESRD and all-cause mortality in Cardiovascular Health Study (CHS) participants.
DESIGN: The CHS is a longitudinal cohort study of community-dwelling adults aged 65 years and older.
PARTICIPANTS: 1,268 participants with an estimated glomerular filtration rate (eGFR) < 60 ml/min per 1.73 m(2) were followed until the time of first event (ESRD, cardiovascular or non-cardiovascular death) or until March 31, 2003.
MAIN MEASURES: The outcomes were ESRD, cardiovascular- and non-cardiovascular death. Rates of each event were calculated, and a Cox Proportional Hazards Model with a competing risk framework was used to examine risk factors for ESRD as compared with death. Predictors included age, gender, race, BMI, hypertension, diabetes, cardiovascular disease, heart failure, tobacco use, eGFR, and total cholesterol.
KEY RESULTS: During 9.7 years of follow-up, 5% of the cohort progressed to ESRD, and 61% of the cohort died. The rate (per 100 person-years) was 0.5 for ESRD and 6.8 for all-cause mortality (3.0 for cardiovascular and 3.8 for non-cardiovascular mortality). In the competing risk framework, lower eGFR, male gender, African-American race, and higher BMI were associated with an increased risk of ESRD.
CONCLUSIONS: Older adults with CKD are 13-fold more likely to die from any cause than progress to ESRD and are 6-fold more likely to die from cardiovascular causes than develop ESRD.
10aAged10aAged, 80 and over10aCause of Death10aCohort Studies10aFemale10aFollow-Up Studies10aHumans10aKidney Failure, Chronic10aLongitudinal Studies10aMale10aProspective Studies10aRenal Insufficiency, Chronic10aRisk Factors10aTreatment Outcome1 aDalrymple, Lorien, S1 aKatz, Ronit1 aKestenbaum, Bryan1 aShlipak, Michael, G1 aSarnak, Mark, J1 aStehman-Breen, Catherine1 aSeliger, Stephen1 aSiscovick, David1 aNewman, Anne, B1 aFried, Linda uhttps://chs-nhlbi.org/node/123003861nas a2200565 4500008004100000022001400041245010700055210006900162260001500231300001100246490000700257520230700264653001602571653000902587653001002596653001502606653001502621653002402636653001102660653003102671653001102702653001402713653001102727653001802738653002502756653000902781653003102790653002202821653003002843653001402873653003202887653002402919653003302943653001702976653001702993653001503010653001803025653001803043100001803061700001603079700002203095700001703117700002703134700002203161700001703183700001703200700002103217700002103238856003603259 2015 eng d a1555-905X00aNT-proBNP and troponin T and risk of rapid kidney function decline and incident CKD in elderly adults.0 aNTproBNP and troponin T and risk of rapid kidney function declin c2015 Feb 6 a205-140 v103 aBACKGROUND AND OBJECTIVES: Elevations in N-terminal pro-B-type natriuretic peptide and high-sensitivity troponin T are associated with poor cardiovascular outcomes. Whether elevations in these cardiac biomarkers are associated with decline in kidney function was evaluated.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: N-terminal pro-B-type natriuretic peptide and troponin T were measured at baseline in 3752 participants free of heart failure in the Cardiovascular Health Study. eGFR was determined from the Chronic Kidney Disease Epidemiology Collaboration equation using serum cystatin C. Rapid decline in kidney function was defined as decline in serum cystatin C eGFR≥30%, and incident CKD was defined as the onset of serum cystatin C eGFR<60 among those without CKD at baseline (n=2786). Cox regression models were used to examine the associations of each biomarker with kidney function decline adjusting for demographics, baseline serum cystatin C eGFR, diabetes, and other CKD risk factors.
RESULTS: In total, 503 participants had rapid decline in serum cystatin C eGFR over a mean follow-up time of 6.41 (1.81) years, and 685 participants developed incident CKD over a mean follow-up time of 6.41 (1.74) years. Participants in the highest quartile of N-terminal pro-B-type natriuretic peptide (>237 pg/ml) had an 67% higher risk of rapid decline and 38% higher adjusted risk of incident CKD compared with participants in the lowest quartile (adjusted hazard ratio for serum cystatin C eGFR rapid decline, 1.67; 95% confidence interval, 1.25 to 2.23; hazard ratio for incident CKD, 1.38; 95% confidence interval, 1.08 to 1.76). Participants in the highest category of troponin T (>10.58 pg/ml) had 80% greater risk of rapid decline compared with participants in the lowest category (adjusted hazard ratio, 1.80; 95% confidence interval, 1.35 to 2.40). The association of troponin T with incident CKD was not statistically significant (hazard ratio, 1.17; 95% confidence interval, 0.92 to 1.50).
CONCLUSIONS: Elevated N-terminal pro-B-type natriuretic peptide and troponin T are associated with rapid decline of kidney function and incident CKD. Additional studies are needed to evaluate the mechanisms that may explain this association.
10aAge Factors10aAged10aAging10aBiomarkers10aCystatin C10aDisease Progression10aFemale10aGlomerular Filtration Rate10aHumans10aIncidence10aKidney10aLinear Models10aLongitudinal Studies10aMale10aNatriuretic Peptide, Brain10aPeptide Fragments10aPredictive Value of Tests10aPrognosis10aProportional Hazards Models10aProspective Studies10aRenal Insufficiency, Chronic10aRisk Factors10aTime Factors10aTroponin T10aUnited States10aUp-Regulation1 aBansal, Nisha1 aKatz, Ronit1 aDalrymple, Lorien1 ade Boer, Ian1 aDeFilippi, Christopher1 aKestenbaum, Bryan1 aPark, Meyeon1 aSarnak, Mark1 aSeliger, Stephen1 aShlipak, Michael uhttps://chs-nhlbi.org/node/666101271nas a2200433 4500008004100000022001400041245011500055210006900170260001200239300001000251490000700261653000900268653001900277653001500296653001500311653001100326653001500337653003100352653001100383653004200394653002000436653002500456653000900481653001400490653003300504100001800537700001600555700002100571700002700592700002000619700002300639700002400662700002000686700002200706700003000728700001900758700002400777856003600801 2016 eng d a1523-683800aGalectin-3 and Soluble ST2 and Kidney Function Decline in Older Adults: The Cardiovascular Health Study (CHS).0 aGalectin3 and Soluble ST2 and Kidney Function Decline in Older A c2016 06 a994-60 v6710aAged10aCohort Studies10aCreatinine10aCystatin C10aFemale10aGalectin 310aGlomerular Filtration Rate10aHumans10aInterleukin-1 Receptor-Like 1 Protein10aLogistic Models10aLongitudinal Studies10aMale10aPrognosis10aRenal Insufficiency, Chronic1 aBansal, Nisha1 aKatz, Ronit1 aSeliger, Stephen1 aDeFilippi, Christopher1 aSarnak, Mark, J1 aDelaney, Joseph, A1 aChristenson, Robert1 ade Boer, Ian, H1 aKestenbaum, Bryan1 aRobinson-Cohen, Cassianne1 aIx, Joachim, H1 aShlipak, Michael, G uhttps://chs-nhlbi.org/node/809502591nas a2200205 4500008004100000022001400041245012300055210006900178260001600247520190400263100002402167700002102191700002702212700002402239700002602263700002002289700002002309700002002329856003602349 2020 eng d a1879-191300aRelation of Biomarkers of Cardiac Injury, Stress, and Fibrosis With Cardiac Mechanics in Patients ≥ 65 Years of Age.0 aRelation of Biomarkers of Cardiac Injury Stress and Fibrosis Wit c2020 Sep 163 aHigh sensitivity cardiac troponin T (hscTnT), soluble ST2 (sST2), N-terminal B-type natriuretic peptide (NT-proBNP), and galectin-3 are biomarkers of cardiac injury, stress, myocardial stretch, and fibrosis. Elevated levels are associated with poor outcomes. However, their association with cardiac mechanics in older persons is unknown. Associations between these biomarkers and cardiac mechanics derived from speckle tracking echocardiography, including left ventricular longitudinal strain (LVLS), early diastolic strain, and left atrial reservoir strain (LARS) were evaluated using standardized beta coefficients () in a cross sectional analysis with cardiac biomarkers in older patients without cardiovascular disease, low ejection fraction, or wall motion abnormalities. Biomarker associations with strain were attenuated by demographics and risk factors. In adjusted models, LVLS was associated with continuous measures of hscTnT (β-0.06, p = 0.020), sST2 (β -0.05, p = 0.024) and NT-proBNP (β -0.06, p = 0.007). "High" levels (i.e., greater than prognostic cutpoint) of hscTnT (>13 ng/ml), sST2 (>35 ng/ml), and NT-proBNP (>190 pg/ml) were also associated with worse LVLS. In risk factor adjusted models, LARS was associated with hscTnT (β -0.08, p = 0.003) and NT-proBNP (β-0.18, p <0.0001). High hscTnT (>13 ng/ml) and high NT-proBNP (>190 pg/ml) were also both associated with worse LARS. Gal-3 was not associated with any strain measure. In conclusion, in persons ≥ 65 years of age, without cardiovascular disease, low ejection fraction, or wall motion abnormalities, hscTnT, sST2, and NT-proBNP are associated with worse LVLS. HscTnT and NT-proBNP are associated with worse LARS. In conclusion, these subclinical increases in blood biomarkers, and their associations with subtle diastolic and systolic dysfunction, may represent pre-clinical heart failure.
1 aGottdiener, John, S1 aSeliger, Stephen1 aDeFilippi, Christopher1 aChristenson, Robert1 aBaldridge, Abigail, S1 aKizer, Jorge, R1 aPsaty, Bruce, M1 aShah, Sanjiv, J uhttps://chs-nhlbi.org/node/8482