Abstract 10554: Carotid Intima-Media Thickness is Associated With Incident Heart Failure Among Middle-Aged Whites and Blacks The Atherosclerosis Risk in Communities Study
Background: Atherosclerotic coronary heart disease (CHD) is a leading cause of heart failure (HF). Greater carotid intima-media thickness (IMT), a measure of subclinical atherosclerosis, is associated with both incident CHD and subclinical left ventricular myocardial dysfunction.
Objective: To investigate the association of increasing carotid IMT with incident HF in the Atherosclerosis Risk In Communities (ARIC) study, a community-based prospective cohort study.
Methods: Carotid IMT, measured by B-mode ultrasound, was available for 13,590 ARIC participants who were aged 45-64 years and free of HF at baseline. HF was defined using ICD-9 428 and ICD-10 I-50 codes from hospitalization records and death certificates. Cox proportional hazards analysis was used with models adjusted for major CVD risk factors and interim CHD to investigate the association between IMT and incident HF.
Results: There were 2,008 incident HF cases over a median follow-up of 20.6 years (8.1 cases per 1,000 person-years). Mean IMT was higher for participants with incident HF than those without (0.81 mm ± 0.23 vs 0.71 mm ± 0.17, p<0.001). After multivariable adjustment, each standard deviation (0.18 mm) increase in IMT was significantly associated with incident HF; hazard ratio 1.20 (95%CI: 1.16-1.25). Results were similar across race and gender groups. Compared to subjects in the first quartile of IMT, those in the fourth quartile had a four-fold higher rate of HF per 1000 person-years (Table 1). The fourth quartile was significantly associated with incident HF after adjustment for CVD risk factors and interim CHD.
Conclusions: Baseline mean carotid IMT is strongly associated with incident HF in this population of middle-aged whites and blacks, independent of CVD risk factors and CHD. This suggests that subclinical atherosclerosis may contribute to incident HF through mechanisms different from clinical myocardial ischemia or infarction.
- © 2013 by American Heart Association, Inc.