Subclinical cardiovascular disease and frailty risk: the atherosclerosis risk in communities study.

Abstract

BACKGROUND:

Cardiovascular disease (CVD) is associated with a greater frailty risk, but it remains unknown if pathways that contribute to CVD are associated with the frailty risk. Thus, we aimed to investigate whether elevations in high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) for those without known CVD at baseline are associated with a higher frailty risk.

METHODS:

This study used data from the Atherosclerosis Risk in Communities study. Cardiac biomarkers were measured from stored plasma samples collected at Visit 2 (1991-1993). Frailty was recorded at Visit 5 (2011-2013). Cox regression models were used to determine the association of cardiac biomarkers with frailty risk.

RESULTS:

Overall, 360/5199 (6.9%) participants aged 55.1 ± 5.1 years developed frailty during a median follow-up of 21.7 years. The incidence of frailty was significantly higher in participants with hs-cTnT ≥14 ng/L (vs. < 14 ng/L: 17.9% vs. 6.7%) or NT-proBNP ≥300 pg/ml (vs. < 300 pg/ml: 19.7% vs. 6.8%) (all P < 0.001). Comparing higher vs. lower cut-off levels of either hs-cTnT (14 ng/l) or NT-proBNP (300 pg/ml) demonstrated a greater than two-fold higher frailty risk, with hazard ratios (HRs) of 2.13 (95% confidence interval (CI): 1.130-4.01, P = 0.020) and 2.61 (95% CI: 1.28-5.33, P = 0.008), respectively. Individuals with both elevated hs-cTnT and NT-proBNP had a higher frailty risk than those without it (HR: 4.15; 95% CI: 1.50-11.48, P = 0.006).

CONCLUSIONS:

High hs-cTnT and NT-proBNP levels are strongly associated with incident frailty in the community-dwelling population without known CVD. Subclinical cardiac damage (hs-cTnT) and/or wall strain (NT-proBNP) may be the key pathway of CVD patients developing frailty. Detection of hs-cTnT and NT-proBNP may help for early screening of high-risk frailty and providing individualised intervention.

TRIAL REGISTRATION:

URL: https://www.

CLINICALTRIALS:

gov ; Unique identifier: NCT00005131 .

• Authors: Yu Jia, Dongze Li, Jing Yu, Yi Liu, Fanghui Li, Wentao Li, Qin Zhang, Yongli Gao, Wei Zhang, Zhi Zeng, Rui Zeng, Xiaoyang Liao, Qian Zhao, Zhi Wan
• Journal: BMC geriatrics (BMC Geriatr) Vol. 22 Issue 1 Pg. 321 (04 12 2022) ISSN: 1471-2318 [Electronic] England
• PMID: 35413794 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2022. The Author(s).

Chemical References

• Biomarkers
• Peptide Fragments
• Troponin T
• Natriuretic Peptide, Brain

Topics

• Atherosclerosis (diagnosis, epidemiology)
• Biomarkers
• Cardiovascular Diseases (diagnosis, epidemiology)
• Frailty (complications, diagnosis, epidemiology)
• Humans
• Natriuretic Peptide, Brain
• Peptide Fragments
• Risk Factors
• Troponin T