TY - JOUR
T1 - Cardiac biomarkers and subsequent risk of hospitalization with bleeding in the community
T2 - Atherosclerosis risk in communities study
AU - Mathews, Lena
AU - Ishigami, Junichi
AU - Ding, Ning
AU - Hoogeveen, Ron C.
AU - Kucharska-Newton, Anna
AU - Ballantyne, Christie M.
AU - Gottesman, Rebecca
AU - Selvin, Elizabeth
AU - Matsushita, Kunihiro
N1 - Funding Information:
The Atherosclerosis Risk in Communities study has been funded in whole or in part with Federal funds from the National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, under Contract nos. (HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700005I, HHSN26820 1700004I). Dr. Mathews is supported by a training grant (grant Number T32 HL007024) from the National Heart, Lung, and Blood Institute, National Institutes of Health. Dr. Selvin was supported by National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Health grants (grant numbers K24DK 106414, R01DK089174). Roche Diagnostics provided a grant to Baylor College of Medicine for supplies to perform all the assays.
Publisher Copyright:
© 2020 The Authors.
PY - 2020
Y1 - 2020
N2 - Background-—hs-cTnT (high-sensitivity cardiac troponin T), but not NT-proBNP (N-terminal pro–B natriuretic peptide), has been shown to predict bleeding in patients with atrial fibrillation. Whether these biomarkers are independently associated with bleeding in the general population is unknown. Methods and Results-—We used Cox proportional hazards models to examine the association of hs-cTnT and NT-proBNP with incident bleeding (defined by International Classification of Diseases, Ninth Revision [ICD-9] codes) among 9550 middle-aged men and women without a history of cardiovascular disease or bleeding. There were 847 hospitalizations with bleeding (92% from gastrointestinal bleeding) during a median follow-up of 9.0 years. Serum levels of hs-cTnT were associated with bleeding in a graded fashion, with a hazard ratio of 1.28 (95% CI, 1.06–1.59) for 6 to <9 ng/L, 1.52 (1.21–1.91) for 9 to <14, and 2.05 (1.56– 2.69) for ≥14 versus <3 ng/L. For NT-proBNP, the highest category (≥264 versus <42 pg/mL) showed a hazard ratio of 2.00 (1.59–2.61), and the remaining 3 categories had hazard ratios ranging from 1.2 to 1.3. Individuals in the highest category of both hs-cTnT and NT-proBNP had a hazard ratio of 3.03 (1.97–4.68) compared with those in the lowest categories. Conclusions-—In a community-based population, elevated hs-cTnT and NT-proBNP were associated with bleeding-related hospitalizations. These biomarkers may have a high utility in identifying people at high risk for bleeding. There is a need for research on the underlying mechanisms linking subclinical cardiac abnormalities and bleeding.
AB - Background-—hs-cTnT (high-sensitivity cardiac troponin T), but not NT-proBNP (N-terminal pro–B natriuretic peptide), has been shown to predict bleeding in patients with atrial fibrillation. Whether these biomarkers are independently associated with bleeding in the general population is unknown. Methods and Results-—We used Cox proportional hazards models to examine the association of hs-cTnT and NT-proBNP with incident bleeding (defined by International Classification of Diseases, Ninth Revision [ICD-9] codes) among 9550 middle-aged men and women without a history of cardiovascular disease or bleeding. There were 847 hospitalizations with bleeding (92% from gastrointestinal bleeding) during a median follow-up of 9.0 years. Serum levels of hs-cTnT were associated with bleeding in a graded fashion, with a hazard ratio of 1.28 (95% CI, 1.06–1.59) for 6 to <9 ng/L, 1.52 (1.21–1.91) for 9 to <14, and 2.05 (1.56– 2.69) for ≥14 versus <3 ng/L. For NT-proBNP, the highest category (≥264 versus <42 pg/mL) showed a hazard ratio of 2.00 (1.59–2.61), and the remaining 3 categories had hazard ratios ranging from 1.2 to 1.3. Individuals in the highest category of both hs-cTnT and NT-proBNP had a hazard ratio of 3.03 (1.97–4.68) compared with those in the lowest categories. Conclusions-—In a community-based population, elevated hs-cTnT and NT-proBNP were associated with bleeding-related hospitalizations. These biomarkers may have a high utility in identifying people at high risk for bleeding. There is a need for research on the underlying mechanisms linking subclinical cardiac abnormalities and bleeding.
KW - Bleeding
KW - Cardiac troponin T
KW - Gastrointestinal bleeding
KW - Natriuretic peptide
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U2 - 10.1161/JAHA.119.013560
DO - 10.1161/JAHA.119.013560
M3 - Article
C2 - 32114886
AN - SCOPUS:85080840782
VL - 9
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
SN - 2047-9980
IS - 5
M1 - e013560
ER -