Abstract MP02: Plasma Free Fatty Acids are Positively Associated with Incident Heart Failure in the Cardiovascular Health Study
Background: Although plasma free fatty acid (FFA) concentration has been associated with lipotoxicity, apoptosis, and risk of diabetes and coronary heart disease, it is unclear whether FFA levels are associated with heart failure (HF).
Objective: To test the hypothesis that plasma concentration of FFA is positively associated with incident HF in older adults.
Methods: We prospectively analyzed data on 3,859 men and women aged 65+ years from the Cardiovascular Health Study after exclusion of people with prevalent HF (n=436) or missing data on FFA (n=1,018) or covariates (n=575). FFA concentration was measured in duplicate by the Wako enzymatic method. Incident HF was validated by a centralized Events Committee. We used Cox proportional hazards to estimate the hazard ratio of HF per standard deviation (SD) of FFA.
Results: During a median follow up of 10.2 y, 1,184 new cases of HF occurred. In a multivariable model adjusting for age, sex, race, and clinic, each higher SD (0.2 mEq/L) of plasma FFA was associated with 13% (95% CI: 6% to 19%) higher risk of HF (p <0.001). Additional adjustment for education, body mass index, glomerular filtration rate based on cystatin, leisure time physical activity, hormone replacement therapy, alcohol intake, self-reported general health status, smoking, prevalent hypertension, unintentional weight loss, and serum albumin did not alter the findings (corresponding HR=1.11 (95% CI: 1.04-1.18)]. Findings were similar in a secondary analysis controlling for time-varying diabetes and coronary heart disease [HR per SD: 1.14 (95% CI: 1.07-1.22)]. Restricting follow up to the first 5 years or stratification by HF with and without antecedent coronary disease did not alter the results.
Conclusion: A single measure of plasma FFA obtained later in life was associated with a higher risk of HF in older adults. Additional studies are needed to explore biologic mechanisms by which FFA may influence the risk of HF and determine whether FFA could serve as a novel pharmacological target in HF.
- © 2013 by American Heart Association, Inc.