Abstract 11673: Soluble Tumor Necrosis Factor Receptors and Heart Failure Risk in Older Adults: The Health, Aging, and Body Composition Study
Background: Tumor necrosis factor (TNF) is known to directly affect myocyte contractility and cardiac remodeling in experimental models and higher TNF levels are associated with increased risk for heart failure (HF) in humans. The soluble TNF receptors type 1 (sTNFR1) and type 2 (sTNFR2) are elevated in patients with HF. However, whether these receptors modulate risk for incident HF is unclear.
Methods: Using Cox proportional hazard models, we examined the association between baseline levels of sTNF-R1 and sTNF-R2 and incident HF risk among 1285 participants of the Health ABC Study (age, 74±2.9 years; 51.4% female; 41.1% black) who were free of HF at baseline. In multivariable models, we adjusted for previously identified risk factors for HF in the Health ABC Study.
Results: At baseline, TNF, sTNF-R1, and sTNF-R2 levels were 3(2.4-4.1) pg/ml, 1.46(1.25-1.76) ng/ml, and 3.43(2.95-4.02) ng/ml respectively. During follow-up (median 11.4 [6.9, 11.7] years), 233 (18.1%) participants developed incident HF. In models controlling for other HF risk factors, sTNF-R1 was associated with a significantly higher risk for HF per log2 increase (hazard ratio [HR], 1.68; 95% confidence interval [CI], 1.15 to 2.46). sTNF-R2 was not associated with a significantly higher risk for HF per log2 increase (HR, 1.15; 95% CI, 0.80-1.63). Levels of sTNF-R1 and sTNF-R2 and incident HF risk were similar across whites vs. blacks, and in both genders. (Table) With death as a competing risk, neither receptor was associated with a significantly higher risk for HF per log2 increase (sTNF-R1: HR, 1.40; 95% CI, 0.92 to 2.13, sTNF-R2: HR, 1.0; 95% CI, 0.69 to 1.45)..
Conclusions: In older adults, elevated levels of sTNF-R1 are associated with increased risk for incident HF. This association is attenuated when the competing risk of death in older adults is taken into account.
- © 2012 by American Heart Association, Inc.