Journal article
Abstract 13478: Trajectories of Time-Varying Changes in Adiposity, Metabolic Syndrome and Coronary Artery Calcium Significantly Predict Risks of Heart Failure and Its Subtypes in The Multi-Ethnic Study of Atherosclerosis
Circulation (New York, N.Y.), v 140(Suppl_1 Suppl 1), pp A13478-A13478
19 Nov 2019
Abstract
IntroductionTrajectories of adiposity, metabolic syndrome (MS) and coronary artery calcium (CAC) (assessed at multiple points in time) may indicate a significant signal for the development of heart failure (HF). However, data for the research is limited.HypothesisWe hypothesized that trajectories of time-varying changes in adiposity, MS and CAC significantly predict risks of HF and its subtypes.MethodsWe analyzed data from the Multi-Ethnic Study of Atherosclerosis, an ongoing cohort study that aims to investigate the risk of cardiovascular disease in individuals aged 45-84 at baseline (N=6814). MS and CAC were assessed in Exams (E)1 to 5 over time. Risks of clinically adjudicated HF and its subtypes HFrEF (EF≤45%) and HFpEF (EF>45%) associated with BMI (≥30 kg/m) and five components of MS (waist circumference (WC>120/80 cm in M/F), high blood pressure (SBP/DBP ≥130/85 mmHg), triglyceride (TG≥150 mg/dL) and fasting glucose (≥100 mg/dL), and low HDL (<40/50 mg/dL in M/F)), and with MS (≥3 of the five components), and CAC (≥400 vs. <400) were examined using Cox’s regression time-varying effect modeling with adjustment for key covariates.ResultsDuring a mean 12.2-year follow-up (2000-2015), the incidence of total HF was 4.0 per 1000 person-years. Of 331 HF, 45.6% were HFrEF, 40.8% HFpEF, and 13.6% with missing EF. The prevalence of MS varied across exams36.0% (E1), 40.1% (E2), 38.8 (E3), 39.3% (E4), and 36.5% (E5). After adjusting for covariates, BMI, TG, glucose, and HDL significantly predicted risk of total HF; and TG and HDL predicted HFrEF; and BMI, WC, TG, glucose and HDL predicated HFpEF. After adjustment including CAC, time-varying MS significantly predicted risk of total incident HF (HR, 95%CI)1.4 (1.2-1.7, p<.001), and HFpEF (1.7, 1.3-2.2, p<.001), but nonsignificant for HFrEF (1.2, 0.9-1.6, p=0.13). The HRs (95%CIs) of CAC were 3.2 (2.7-3.9, p<.001) for total incident HF, 3.3 (2.5-4.4, p<.001) for HFrEF, and 3.2 (2.3-4.3, p<.001) for HFpEF respectively. Further sensitivity analyses by control competing risk from death did not change the overall results.ConclusionsTrajectories of time-varying changes in adiposity, MS, and CAC significantly predicted risks of HF and its subtypes. Continued effort to control these factors is recommended.
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Details
- Title
- Abstract 13478: Trajectories of Time-Varying Changes in Adiposity, Metabolic Syndrome and Coronary Artery Calcium Significantly Predict Risks of Heart Failure and Its Subtypes in The Multi-Ethnic Study of Atherosclerosis
- Creators
- Longjian Liu - Drexel UniversityJoao Lima - Johns Hopkins UniversityWendy Post - Johns Hopkins UniversityMoyses Szklo - Johns Hopkins University
- Publication Details
- Circulation (New York, N.Y.), v 140(Suppl_1 Suppl 1), pp A13478-A13478
- Publisher
- by the American College of Cardiology Foundation and the American Heart Association, Inc
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Other Identifier
- 991020594691704721