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High-sensitivity cardiac troponin T and the risk of heart failure in postmenopausal women of the ARIC Study.

TitleHigh-sensitivity cardiac troponin T and the risk of heart failure in postmenopausal women of the ARIC Study.
Publication TypeJournal Article
Year of Publication2021
AuthorsEbong IA, Wilson MD, Bertoni AG, Appiah D, Polonsky T, Michos ED, Ballantyne C, Chang P
JournalMenopause
Volume28
Issue3
Pagination284-291
Date Published2021 01 04
ISSN1530-0374
KeywordsAged, Aged, 80 and over, Biomarkers, Female, Heart Failure, Humans, Natriuretic Peptide, Brain, Peptide Fragments, Postmenopause, Proportional Hazards Models, Risk Factors, Troponin T
Abstract

OBJECTIVE: We investigated isolated and joint effects of early menopause (occurrence before 45 y of age) and high-sensitivity cardiac troponin T elevation (hs-cTnT ≥ 14 ng/L) on heart failure (HF) incidence in postmenopausal women.

METHODS: We included 2,276 postmenopausal women, aged 67-90 years, with hs-cTnT measurements and without prevalent HF from the Atherosclerosis Risk in Communities study Visit 5 (2011-2013). Women were categorized according to early menopause and hs-cTnT group. Cox proportional hazards models were used for analysis.

RESULTS: Over a median follow-up of 5.5 years, we observed 104 HF events. The incidence rates of HF were greater in women with hs-cTnT elevation when compared to those without hs-cTnT elevation. In unadjusted analysis, the hazard ratios for incident HF were threefold greater in women with hs-cTnT elevation, with or without early menopause, (3.03 [95% CI, 1.59-5.77]) and (3.29 [95% CI, 2.08-5.21]), respectively, but not significantly greater in women with early menopause without hs-cTnT elevation, when compared to women with neither early menopause nor hs-cTnT elevation at Visit 5. After adjusting for HF risk factors and NT-pro B-type natriuretic peptide, these associations were attenuated and became nonsignificant for women with hs-cTnT elevation, but became stronger and significant for women with early menopause without hs-cTnT elevation (2.39 [95% CI, 1.28-4.46]).

CONCLUSIONS: Irrespective of early menopause status, hs-cTnT elevation is associated with greater HF incidence but this association is partially explained by HF risk factors. Even in the absence of hs-cTnT elevation, early menopause is significantly associated with HF incidence after accounting for HF risk factors.

DOI10.1097/GME.0000000000001705
Alternate JournalMenopause
PubMed ID33399316
Grant ListHHSN268201700001I / HL / NHLBI NIH HHS / United States
HHSN268201700002I / HL / NHLBI NIH HHS / United States
HHSN268201700003I / HL / NHLBI NIH HHS / United States
HHSN268201700005I / HL / NHLBI NIH HHS / United States
HHSN268201700004I / HL / NHLBI NIH HHS / United States
UL1 TR001860 / TR / NCATS NIH HHS / United States
R01 HL134320 / HL / NHLBI NIH HHS / United States