Title | Myocardial Injury, Obesity, and the Obesity Paradox: The ARIC Study. |
Publication Type | Journal Article |
Year of Publication | 2017 |
Authors | Pokharel Y, Sun W, Virani SS, Nambi V, Hoogeveen RC, Chang PP, Ndumele CE, Solomon SD, Bozkurt B, Selvin E, Ballantyne CM |
Secondary Authors | Deswal A |
Journal | JACC Heart Fail |
Volume | 5 |
Issue | 1 |
Pagination | 56-63 |
Date Published | 2017 01 |
ISSN | 2213-1787 |
Keywords | Aged, Biomarkers, Cardiomyopathies, Cohort Studies, Female, Heart Failure, Hospitalization, Humans, Male, Middle Aged, Obesity, Sensitivity and Specificity, Survival Rate, Troponin T |
Abstract | OBJECTIVES: This study sought to determine whether pre-heart failure (HF) myocardial injury explains the differential mortality after HF across weight categories. BACKGROUND: Obesity is a risk factor for HF, but pre-HF obesity is associated with lower mortality after incident HF. High-sensitivity cardiac troponin T (hs-cTnT) is a sensitive marker of myocardial injury, and predicts incident HF and mortality. METHODS: Stratifying 1,279 individuals with incident HF hospitalizations by their pre-HF hs-cTnT levels ( RESULTS: Mean age at HF was 74 years (53% women, 27% black). Individuals with pre-HF hs-cTnT ≥14 ng/l had higher mortality after incident HF (hazard ratio [HR]: 1.46; 95% confidence interval [CI]: 1.18 to 1.80) compared to individuals with hs-cTnT CONCLUSION: Although greater pre-existing subclinical myocardial injury was associated with higher mortality after incident HF hospitalization, it did not explain the obesity paradox in HF, which was observed irrespective of subclinical myocardial injury. (Atherosclerosis Risk In Communities [ARIC]; NCT00005131). |
DOI | 10.1016/j.jchf.2016.10.010 |
Alternate Journal | JACC Heart Fail |
PubMed ID | 28017350 |
PubMed Central ID | PMC5425302 |
Grant List | HHSN268201100012C / HL / NHLBI NIH HHS / United States HHSN268201100010C / HL / NHLBI NIH HHS / United States HHSN268201100008C / HL / NHLBI NIH HHS / United States R01 DK089174 / DK / NIDDK NIH HHS / United States HHSN268201100007C / HL / NHLBI NIH HHS / United States HHSN268201100011C / HL / NHLBI NIH HHS / United States HHSN268201100006C / HL / NHLBI NIH HHS / United States K24 DK106414 / DK / NIDDK NIH HHS / United States HHSN268201100009C / HL / NHLBI NIH HHS / United States HHSN268201100005C / HL / NHLBI NIH HHS / United States |