Abstract Details

Title Serum Cardiac Biomarkers Independently Predict Risk of Stroke in older Adults: The Cardiovascular Health Study

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) IN7 - (-)

Poster/Presentation
Number 002

Objective

Background Cardiac disorders are associated with stroke risk, but whether biomarkers associated with atrial fibrillation (AF), heart failure (HF), and cardiac injury predict stroke in prospective cohorts remains undetermined.

Design/Methods We analyzed data from 4189 older adults in the Cardiovascular Health Study who were without stroke at baseline and with enrollment serum biomarkers available. Cox proportional-hazards models were used to estimate associations of biomarker concentrations with risk of ischemic and total stroke. We adjusted for demographics and traditional cardiovascular risk factors and tested for mediation by AF, HF, and left ventricular hypertrophy (LVH).

Results Median concentration for NT-proBNP was 114.2 (interquartile range (IQR) 57.7-230.1) pg/ml; 67% of participants had cTnT concentrations above the lower limit of detection, and for those participants, median (IQR) was 8.2 (5.5-13.2) pg/ml. Higher concentrations of both biomarkers were associated with ischemic stroke risk with similar magnitude: for each doubling of levels, the adjusted hazard ratio and 95% confidence interval (HR, 95% CI) was 1.13, 1.07-1.19 for NT-proBNP and 1.16, 1.06-1.26 for cTnT. Compared to the lowest NT-proBNP quintile, those in the top quintile had HR 1.66, 1.26-2.18. Compared to those with undetectable cTnT, those in quintile 4 had HR 1.44, 1.12-1.84 and those in quintile 5 had HR 1.64, 1.25-2.15. Further adjusting for AF, HF and LVH changed results minimally. There was no interaction between the two biomarkers, and each was independently predictive after adjusting for the other biomarker. Results were similar for total stroke.

Conclusions Biomarkers reflecting cardiac structure, function, and injury are associated with risk of ischemic stroke, and provide prognostic information beyond that provided by conventional cardiac history and evaluation. Further study of these biomarkers may lead to improved approaches to stroke prevention.

Authors/Disclosures
Mitchell S. Elkind, MD, MS, FAAN PRESENTER	Dr. Elkind has received personal compensation for serving as an employee of American Heart Association. Dr. Elkind has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Atria Academy.
	No disclosure on file
David J. Rintell	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Rebecca F. Gottesman, MD (Johns Hopkins University)	The institution of Dr. Gottesman has received research support from NIH.
	No disclosure on file
W. T. Longstreth, Jr., MD, FAAN (Harborview Medical Center)	The institution of Dr. Longstreth has received research support from NIH.

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