Title | High-sensitivity cardiac troponin T and the risk of heart failure in postmenopausal women of the ARIC Study. |
Publication Type | Journal Article |
Year of Publication | 2021 |
Authors | Ebong IA, Wilson MD, Bertoni AG, Appiah D, Polonsky T, Michos ED, Ballantyne C, Chang P |
Journal | Menopause |
Volume | 28 |
Issue | 3 |
Pagination | 284-291 |
Date Published | 2021 01 04 |
ISSN | 1530-0374 |
Keywords | Aged, 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. |
DOI | 10.1097/GME.0000000000001705 |
Alternate Journal | Menopause |
PubMed ID | 33399316 |
Grant List | HHSN268201700001I / 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 |