Abstract 16981: Gender-specific Differences in High-sensitive Cardiac Troponin T and B-type Natriuretic Peptides Across the Spectrum of Aging in CVD-Free Adults: The Multi-Ethnic Study of Atherosclerosis (MESA)
Introduction: High sensitive cardiac troponin T (hs-cTnT) and amino-terminal proBNP (NT-proBNP) as measures of myocyte injury and neurohormonal activation can predict risk of heart failure and cardiovascular (CV) death in general populations. Little is known about the relationship of each measure with aging, and whether these relationships differ by gender.
Hypothesis: Evidence of myocyte injury precedes neurohormonal activation as a function of older age in adults free of CV disease (CVD).
Methods: At baseline 4986 CVD-free adults age 45-84 participating in the MESA study and with cardiac magnetic resonance (CMR) imaging had hs-cTnT and NT-proBNP measured from previously frozen plasma (Cobas e601, Roche Diagnostics). We estimated the linear correlation between the two markers among age subgroups, and we plotted median hs-cTnT and NT-proBNP as a function of age among men and women separately, using locally weighted (lowess) regression.
Results: Participant age was 61.5±10.1 years and 47.6% were male. There was no correlation between hs-cTnT and NT-proBNP among those <60 years (p=0.4), but modest positive correlation among those ≥60 (r=0.25, p<.001). The association of each biomarker across age differed markedly by gender (figure). Among men, there was a near linear increase in hs-cTnT from 45 to 84 years, in contrast to a steep increase in NT-proBNP levels after age 65. Among women, hs-cTnT levels are lower than men at any age, but levels increase more rapidly by 65-75 years of age. In contrast, NT-proBNP levels differ only modestly across middle to older age in women.
Conclusions: In CVD-free individuals, subclinical myocyte injury as evidenced by hs-cTnT appears to precede cardiac neurohormonal activation until older adulthood, particularly in men. These findings suggest distinct pathophysiological signatures of troponins and natriuretic peptides and highlight important age and sex based influences on these biomarkers.
Author Disclosures: C. deFilippi: Research Grant; Significant; Roche Diagnostics, Critical Diagnostics. Other Research Support; Modest; Siemens Healthcare Diagnostics. Honoraria; Modest; Roche Diagnostics, Siemens Healthcare Diagnostics. Consultant/Advisory Board; Modest; Roche Diagnostics, Ortho Diagnostics. Consultant/Advisory Board; Significant; Siemens Healthcare Diagnostics. Other; Modest; Quintiles-DSMB, ajudicator. Other; Significant; Radiometer-Ajudicator. J. deLemos: Other Research Support; Significant; Roche Diagnostics; Abbot. Consultant/Advisory Board; Significant; Radiometer; Siemens Healthcare; Roche Diagnostics. S. Hong-Zohlman: Other Research Support; Modest; Roche Diagnostics. L.B. Daniels: Research Grant; Modest; Siemens Healthcare. Speakers Bureau; Modest; Roche Diagnostics. Consultant/Advisory Board; Modest; diaDexus. R. Christenson: Research Grant; Modest; Roche Diagnostics. Speakers Bureau; Modest; Roche Diagnostics; Siemens Diagnostics. Consultant/Advisory Board; Modest; Roche Diagnostics, Siemens Diagnostics, BD Life Sciences, Phillips. J. Lima: None. A. Bertoni: None. S. Seliger: Research Grant; Significant; Roche Diagnostics. Consultant/Advisory Board; Significant; Abbvie.
- © 2016 by American Heart Association, Inc.