To evaluate the association of obesity with a novel biomarker of subclinical myocardial injury, cardiac troponin T measured with a new high sensitivity assay (hs-cTnT), among adults without clinical cardiovascular disease (CVD).
Laboratory evidence suggests a relationship between obesity andmyocardial injury that may play a role in the development of heart failure (HF), but there is limited clinical data regarding this association.
We evaluated 9,507 participants in the Atherosclerosis Risk in Communities Study without baseline CVD (Visit 4, 1996-1999). We assessed the cross sectional association of body-mass index (BMI) with high (≥14 ng/L) and measurable (≥3 ng/L) hs-cTnT levels after multivariable regression. We further evaluated the independent and combined associations of BMI and hs-cTnT with incident HF.
Higher BMI was independently associated with a positive, linear increase in the likelihood of high hs-cTnT, with severe obesity (BMI >35 kg/m2) associated with an odds ratio of 2.20 (95% CI: 1.59-3.06) for high hs-cTnT after adjustment. Over 12 years of follow-up, there were 869 incident HF events. Obesity and hs-cTnT were both independently associated with incident HF, and individuals with severe obesity and high hs-cTnT had a greater than 9-fold higher risk of incident HF (HR 9.20 [95% CI: 5.67-14.93]) than individuals with normal weight and undetectable hs-cTnT.
Among individuals without CVD, higher BMI has an independent, linear association with subclinical myocardial injury, as assessed by hs-cTnT levels. Obesity and hscTnT provide independent and complementary prognostic information regarding the risk of incident HF.