Document Type

Journal Article

Publication Title

Heart

Publisher

BMJ Publishing Group

School

School of Medical and Health Sciences / Institute for Nutrition Research

RAS ID

39871

Comments

This article has been accepted for publication in Heart, 2021, following peer review, and the Version of Record can be accessed online at https://doi.org/10.1136/heartjnl-2021-319879

© Authors (or their employer(s)) 2021.

Teh, R., Prince, R. L., Sim, M., Schousboe, J. T., Raymond, W. D., Szulc, P., . . . Lewis, J. R. (2022). Abdominal aortic calcification, cardiac troponin I and atherosclerotic vascular disease mortality in older women. Heart, 108, 1274-1280.

https://doi.org/10.1136/heartjnl-2021-319879

Abstract

Objective:

Examine if two inexpensive measures of atherosclerotic vascular diseases (ASVD), abdominal aortic calcification (AAC) and high-sensitivity cardiac troponin I (hs-cTnI) provide complementary information for 10-year ASVD mortality and all-cause mortality risk in older women.

Methods:

908 community-dwelling women without prevalent ASVD ( ≥ 75 years) were followed-up between 2003 and 2013. AAC and plasma hs-cTnI measures were obtained in 2003. AAC was assessed on lateral spine images using a semiquantitative method (AAC24). Linked health records were used for mortality outcomes.

Results:

Mean±SD age was 79.9±2.6 years. 276 (30.4%) women died during follow-up, including 138 (15.2%) ASVD-related deaths. AAC24 and hs-cTnI were independently associated with ASVD and all-cause mortality (p 1) and < median hs-cTnI (n=280), (3) low AAC24 and ≥ median hs-cTnI (n=148) and (4) moderate-extensive AAC24 and ≥ median hs-cTnI (n=317). Compared with the referent group, a stepwise increase in relative hazard (HR (95% CI)) for ASVD mortality was seen at 2.39 (1.05 to 5.46), 3.18 (1.35 to 7.79) and 5.38 (2.44 to 11.85), respectively. A similar associations were observed for all-cause mortality, at 1.58 (0.99–2.52), 2.38 (1.46–3.89) and 3.02 (1.93–4.72), respectively (all p < 0.05).

Conclusion:

Higher AAC and elevated hs-cTnI were associated with higher risk of ASVD mortality and all-cause mortality, independent of each other. Stratifying by moderate to extensive AAC and elevated hs-cTnI identified women at very high risk. Further studies investigating whether combining factors may improve risk prediction are needed.

DOI

10.1136/heartjnl-2021-319879

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