Bakhshi Hooman, Varadarajan Vinithra, Ambale-Venkatesh Bharath, Meyghani Zahra, Ostovaneh Mohammad R, Durda Peter, Wu Colin O, Tracy Russell P, Cushman Mary, Bluemke David A, Lima João A C
Department of Medicine, Division of Cardiology, Johns Hopkins University, Wolfe Street/Blalock 524, Baltimore, MD, 21287, USA.
Inova Heart and Vascular Institute, Falls Church, Virginia, USA.
ESC Heart Fail. 2020 Apr;7(2):639-644. doi: 10.1002/ehf2.12623. Epub 2020 Mar 10.
Soluble tumour necrosis factor-α receptor 1 (sTNF-αR1) and interleukin-2 receptor α (sIL-2Rα) predict incident heart failure (HF) in the elderly population. However, the association of these biomarkers with HF in a multi-ethnic asymptomatic population is unclear. We aimed to investigate the association of sTNF-αR1 and sIL-2Rα with incident HF in a multi-ethnic population of middle age and older participants.
The multi-ethnic study of atherosclerosis is a prospective population-based study of 6814 participants aged 45-84 years who were free of clinical cardiovascular disease at enrolment. We included 2869 participants with available sTNF-αR1 or sIL-2Rα level measurement at baseline multi-ethnic study of atherosclerosis exam (2000-2002). We used Cox proportional-hazards model to investigate the association between sTNF-αR1 and sIL-2Rα with incident HF after adjusting for traditional cardiovascular risk factors and coronary artery calcium score measured by cardiac computed tomography. Among the included participants, the mean (standard deviation) age was 61.6 (10.2) years and 46.7% were men. The median (interquartile range) sTNF-αR1 and sIL-2Rα were 1293 (1107-1547) and 901 (727-1154) pg/mL. During a median follow-up of 14.2 (interquartile range: 11.7-14.8) years, 130 participants developed HF. In multivariable analysis, the hazard ratio (95% confidence interval, P value) of incident HF for each standard deviation increment of log-transformed sTNF-αR1 and sIL-2Rα was 1.43 (1.21-1.7, P ≤ 0.001) and 1.26 (1.04-1.53, P = 0.02), respectively. Excluding participants with interim coronary heart disease, we found a statistically significant association between sTNF-αR1 and HF with hazard ratio of 1.39 (95% confidence interval: 1.11 to 1.74, P = 0.005) and sIL-2Rα and HF showing a hazard ratio of 1.39 (95% confidence interval: 1.09 to 1.76, P = 0.007).
sTNF-αR1 and sIL-2Rα are associated with a higher risk of incident HF in a multi-ethnic cohort without a previous history of cardiovascular disease.
可溶性肿瘤坏死因子-α受体1（sTNF-αR1）和白细胞介素-2受体α（sIL-2Rα）可预测老年人群发生心力衰竭（HF）。然而，在多民族无症状人群中，这些生物标志物与HF的关联尚不清楚。我们旨在研究sTNF-αR1和sIL-2Rα与中老年多民族人群发生HF的关联。
动脉粥样硬化多民族研究是一项基于人群的前瞻性研究，纳入了6814名年龄在45 - 84岁、入组时无临床心血管疾病的参与者。我们纳入了2869名在动脉粥样硬化多民族研究基线检查（2000 - 2002年）时可测量sTNF-αR1或sIL-2Rα水平的参与者。我们使用Cox比例风险模型，在调整了传统心血管危险因素和通过心脏计算机断层扫描测量的冠状动脉钙化评分后，研究sTNF-αR1和sIL-2Rα与发生HF之间的关联。在纳入的参与者中，平均（标准差）年龄为61.6（10.2）岁，男性占46.7%。sTNF-αR1和sIL-2Rα的中位数（四分位间距）分别为1293（1107 - 1547）和901（727 - 1154）pg/mL。在中位随访14.2（四分位间距：11.7 - 14.8）年期间，130名参与者发生了HF。在多变量分析中，log转换后的sTNF-αR1和sIL-2Rα每增加一个标准差，发生HF的风险比（95%置信区间，P值）分别为1.43（1.21 - 1.7，P≤0.001）和1.26（1.04 - 1.53，P = 0.02）。排除患有中期冠心病的参与者后，我们发现sTNF-αR1与HF之间存在统计学显著关联，风险比为1.39（95%置信区间：1.11至1.74，P = 0.005），sIL-2Rα与HF的风险比为1.39（95%置信区间：1.09至1.76，P = 0.007）。
在无心血管疾病既往史的多民族队列中，sTNF-αR1和sIL-2Rα与发生HF的较高风险相关。
