Abstract MP011: Cardiac Markers and Risk for Hospitalization with Infection: The Atherosclerosis Risk in Communities (ARIC) Study
Background: Clinical cardiovascular disease (CVD) is a risk factor for infection, but the association may be confounded by other comorbidities. To better understand the underlying pathophysiology, we explored whether subclinical cardiac biomarkers were associated with infection risk in the general population.
Methods: Using 8,588 individuals free of clinical CVD in the biracial ARIC Study in 1996-98 (mean age 62 years and 22% African American), we assessed the association of high-sensitivity cardiac troponin T (hs-cTnT) and natriuretic peptide (NTproBNP) with risk of hospitalization through 2013 with an infection ICD code anywhere among the listed discharge diagnoses. Cox proportional hazards models were used to estimate hazard ratios (HRs).
Results: During follow-up (median, 15.2 years), 3,308 individuals were discharged with an infection ICD code. The incidence rate increased proportionally with higher hs-cTnT and NTproBNP (Table1). The association did not change in multivariable Cox proportional analyses, and was consistent after further accounting for incident CVD during follow-up (Table1) or restricting to hospitalizations with infection as the primary diagnosis. No interaction was observed for subgroup analysis by age, sex, race, and status of diabetes or chronic kidney disease (eGFR <60 vs. ≥60 ml/min/1.73m2). Although both cardiac markers were associated with different types of infection (pneumonia, urinary tract infections, bloodstream infections, and cellulitis), the association appeared strongest for cellulitis (HR, 1.41 [95%CI, 1.00-2.00] for hsTnT ≥4 vs. <3ng/L; and 1.51 [1.08-2.11] for NTproBNP ≥69 vs. <68 pg/mL).
Conclusions: Higher hs-cTnT and NTproBNP concentrations were independently associated with increased risk for hospitalization with infection, suggesting a potential relationship between cardiac damage/overload and infection.
Author Disclosures: J. Ishigami: None. R. Hoogeveen: None. C. Ballantyne: None. A. Folsom: None. J. Coresh: None. E. Selvin: None. K. Matsushita: None.
- © 2017 by American Heart Association, Inc.