Abstract 17919: Obesity is Independently Associated with Elevated hs-cTnT levels and Risk of Heart Failure

Abstract

Background: Obesity is associated with subclinical cardiovascular disease (CVD) and is a risk factor for incident heart failure (HF). However, the relationship of obesity to subclinical myocardial damage, as assessed by minor elevations in cardiac troponin, is largely uncharacterized. Hypothesis: We hypothesized that obesity is associated with elevated cardiac troponin T, measured with a novel high-sensitivity assay (hs-cTnT), and elevated hs-cTnT is associated with increased risk of HF among obese individuals.

Methods: We conducted a prospective analysis of data from 9,507 ARIC participants with body mass index (BMI) > 18.5 kg/m2 and no history of CVD at baseline (Visit 4, 1996-1999). Multivariable logistic regression was used to characterize the cross-sectional association of BMI categories with hs-cTnT. Cox regression was used to quantify the association of BMI with HF risk among individuals with undetectable (<0.003 µg/L), detectable, or high hs-cTnT (≥0.014 µg/L; 90th percentile in the ARIC population), after adjustment for traditional risk factors.

Results: During a median of 12 years of follow-up there were 873 HF events. After adjustment for traditional cardiovascular risk factors, higher BMI was associated with increased likelihood of detectable hs-cTnT (normal weight: OR 1.00 (reference), overweight: OR 1.00 [95% CI: 0.89-1.13], obese: OR 1.24 [95% CI: 1.07-1.43], severely obese: OR 1.58 [95% CI: 1.32-1.88]). BMI was strongly associated with incident HF, even after adjustment for traditional risk factors (Table). Within each BMI category, higher hs-cTnT levels were associated with greater risk of incident HF, however higher BMI was also associated with increased risk of incident HF among individuals without detectable hs-cTnT.

Conclusion: Obesity is independently associated with elevated troponin measured with a high sensitivity assay. Higher BMI and hs-cTnT are independently and additively associated with increased HF incidence.