TY - JOUR
T1 - Longitudinal Changes in Cardiac Troponin and Risk of Heart Failure Among Black Adults
AU - Saha, Amit
AU - Patel, Kershaw V.
AU - Ayers, Colby
AU - Ballantyne, Christie M.
AU - Correa, Adolfo
AU - Defilippi, Christopher
AU - Hall, Michael E.
AU - Mentz, Robert J.
AU - Seliger, Stephen L.
AU - Yimer, Wondwosen
AU - Butler, Javed
AU - Berry, Jarett D.
AU - De Lemos, James A.
AU - Pandey, Ambarish
N1 - Funding Information:
The authors thank the Jackson Heart Study (JHS) participants, staff, and investigators for their important contributions. The Jackson Heart Study (JHS) is supported and conducted in collaboration with Jackson State University (HHSN268201800013I), Tougaloo College (HHSN268201800014I), the Mississippi State Department of Health (HHSN268201800015I) and the University of Mississippi Medical Center (HHSN268201800010I, HHSN268201800011I, and HHSN268201800012I) contracts from the National Heart, Lung, and Blood Institute (NHLBI) and the National Institute on Minority Health and Health Disparities (NIMHD). The authors also thank Rachael Whitehead, Houston Methodist Research Institute, for helping create the Graphical Abstract.
Funding Information:
Dr de Lemos reported grants from Abbott Diagnostics and Roche Diagnostics; personal fees from Ortho Clinical Diagnostics, Quidel Inc, and Siemen's Health Care Diagnostics.
Funding Information:
Dr Pandey is supported by the Texas Health Resources Clinical Scholars Program, Gilead Sciences Research Scholar Program, the National Institute on Minority Health and Disparities (R01MD017529), and the National Institute of Aging GEMSSTAR Grant (1R03AG067960-01). Dr Pandey has served on the advisory board of Roche Diagnostics.
Funding Information:
Dr Seliger reported grants from Roche Diagnostics and personal fees from Abbvie Inc. In addition, Dr Seliger had a patent to “Methods for Assessing Differential Risk of Developing Heart” pending.
Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2023/1
Y1 - 2023/1
N2 - Background: Among Black adults, high-sensitivity cardiac troponin I (hs-cTnI) is associated with heart failure (HF) risk. The association of longitudinal changes in hs-cTnI with risk of incident HF, HF with reduced and preserved ejection fraction (HFrEF and HFpEF, respectively), among Black adults is not well-established. Methods and Results: This study included Black participants from the Jackson Heart Study with available hs-cTnI data at visits 1 (2000–2004) and 2 (2005–2008) and no history of cardiovascular disease. Cox models were used to evaluate associations of categories of longitudinal change in hs-cTnI with incident HF risk. Among 2423 participants, 11.6% had incident elevation in hs-cTnI at visit 2, and 16.9% had stable or improved elevation (≤50% increase in hs-cTnI), and 4.0% had worsened hs-cTnI elevation (>50% increase). Over a median follow-up of 12.0 years, there were 139 incident HF hospitalizations (64 HFrEF, 58 HFpEF). Compared with participants without an elevated hs-cTnI, those with incident, stable or improved, or worsened hs-cTnI elevation had higher HF risk (adjusted hazard ratio 3.20 [95% confidence interval, 1.92–5.33]; adjusted hazard ratio 2.40, [95% confidence interval, 1.47–3.92]; and adjusted hazard ratio 8.10, [95% confidence interval, 4.74–13.83], respectively). Similar patterns of association were observed for risk of HFrEF and HFpEF. Conclusions: Among Black adults, an increase in hs-cTnI levels on follow-up was associated with a higher HF risk. Lay Summary: The present study included 2423 Black adults from the Jackson Heart Study with available biomarkers of cardiac injury and no history of cardiovascular disease at visits 1 and 2. The majority of participants did not have evidence of cardiac injury at both visits (67.5%), 11.6% had evidence of cardiac injury only on follow-up, 14.5% had stable elevations, 4.0% had worsened elevations, and 2.4% had improved elevations of cardiac injury biomarkers during follow-up. Compared with participants without evidence of cardiac injury, those with new, stable, and worsened levels of cardiac injury had a higher risk of developing heart failure. Tweet: Among Black adults, persistent or worsening subclinical myocardial injury is associated with an elevated risk of HF.
AB - Background: Among Black adults, high-sensitivity cardiac troponin I (hs-cTnI) is associated with heart failure (HF) risk. The association of longitudinal changes in hs-cTnI with risk of incident HF, HF with reduced and preserved ejection fraction (HFrEF and HFpEF, respectively), among Black adults is not well-established. Methods and Results: This study included Black participants from the Jackson Heart Study with available hs-cTnI data at visits 1 (2000–2004) and 2 (2005–2008) and no history of cardiovascular disease. Cox models were used to evaluate associations of categories of longitudinal change in hs-cTnI with incident HF risk. Among 2423 participants, 11.6% had incident elevation in hs-cTnI at visit 2, and 16.9% had stable or improved elevation (≤50% increase in hs-cTnI), and 4.0% had worsened hs-cTnI elevation (>50% increase). Over a median follow-up of 12.0 years, there were 139 incident HF hospitalizations (64 HFrEF, 58 HFpEF). Compared with participants without an elevated hs-cTnI, those with incident, stable or improved, or worsened hs-cTnI elevation had higher HF risk (adjusted hazard ratio 3.20 [95% confidence interval, 1.92–5.33]; adjusted hazard ratio 2.40, [95% confidence interval, 1.47–3.92]; and adjusted hazard ratio 8.10, [95% confidence interval, 4.74–13.83], respectively). Similar patterns of association were observed for risk of HFrEF and HFpEF. Conclusions: Among Black adults, an increase in hs-cTnI levels on follow-up was associated with a higher HF risk. Lay Summary: The present study included 2423 Black adults from the Jackson Heart Study with available biomarkers of cardiac injury and no history of cardiovascular disease at visits 1 and 2. The majority of participants did not have evidence of cardiac injury at both visits (67.5%), 11.6% had evidence of cardiac injury only on follow-up, 14.5% had stable elevations, 4.0% had worsened elevations, and 2.4% had improved elevations of cardiac injury biomarkers during follow-up. Compared with participants without evidence of cardiac injury, those with new, stable, and worsened levels of cardiac injury had a higher risk of developing heart failure. Tweet: Among Black adults, persistent or worsening subclinical myocardial injury is associated with an elevated risk of HF.
KW - Black adults
KW - heart failure
KW - high-sensitivity cardiac troponin I
UR - http://www.scopus.com/inward/record.url?scp=85135468455&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85135468455&partnerID=8YFLogxK
U2 - 10.1016/j.cardfail.2022.05.013
DO - 10.1016/j.cardfail.2022.05.013
M3 - Article
C2 - 35690315
AN - SCOPUS:85135468455
VL - 29
SP - 6
EP - 15
JO - Journal of Cardiac Failure
JF - Journal of Cardiac Failure
SN - 1071-9164
IS - 1
ER -