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Myocardial Injury, Obesity, and the Obesity Paradox: The ARIC Study.

TitleMyocardial Injury, Obesity, and the Obesity Paradox: The ARIC Study.
Publication TypeJournal Article
Year of Publication2017
AuthorsPokharel Y, Sun W, Virani SS, Nambi V, Hoogeveen RC, Chang PP, Ndumele CE, Solomon SD, Bozkurt B, Selvin E, Ballantyne CM
Secondary AuthorsDeswal A
JournalJACC Heart Fail
Volume5
Issue1
Pagination56-63
Date Published2017 01
ISSN2213-1787
KeywordsAged, 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).

DOI10.1016/j.jchf.2016.10.010
Alternate JournalJACC Heart Fail
PubMed ID28017350
PubMed Central IDPMC5425302
Grant ListHHSN268201100012C / 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