Richard L. Prince
Marc Sim, Edith Cowan UniversityFollow
John T. Schousboe
Jonathan M. Hodgson, Edith Cowan UniversityFollow
Douglas P. Kiel
Peter L. Thompson
Joshua Lewis, Edith Cowan UniversityFollow
BMJ Publishing Group
School of Medical and Health Sciences / Institute for Nutrition Research
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.
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.
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).
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.