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Years of able life in older persons--the role of cardiovascular imaging and biomarkers: the Cardiovascular Health Study.
Monday,2015-05-04 13:20 America/Los_Angeles — zdrager
| Title | Years of able life in older persons--the role of cardiovascular imaging and biomarkers: the Cardiovascular Health Study. |
| Publication Type | Journal Article |
| Year of Publication | 2015 |
| Authors | Alshawabkeh, LI, Yee, LM, Gardin, JM, Gottdiener, JS, Odden, MC, Bartz, TM, Arnold, AM, Mukamal, KJ, Wallace, RB |
| Journal | J Am Heart Assoc |
| Volume | 4 |
| Issue | 4 |
| Date Published | 2015 Apr |
| ISSN | 2047-9980 |
| Keywords | Activities of Daily Living, Aged, Biomarkers, Cardiovascular Diseases, Carotid Intima-Media Thickness, Echocardiography, Female, Humans, Independent Living, Male, Natriuretic Peptide, Brain, Peptide Fragments, Procollagen, Prospective Studies, Stroke Volume, Troponin I |
| Abstract | <p><b>BACKGROUND: </b>As the U.S. population grows older, there is greater need to examine physical independence. Previous studies have assessed risk factors in relation to either disability or mortality, but an outcome that combines both is still needed.</p><p><b>METHODS AND RESULTS: </b>The Cardiovascular Health Study is a population-based, prospective study where participants underwent baseline echocardiogram, measurement of carotid intima-media thickness (IMT), and various biomarkers, then followed for up to 18 years. Years of able life (YAL) constituted the number of years the participant was able to perform all activities of daily living. Linear regression was used to model the relationship between selected measures and outcomes, adjusted for confounding variables. Among 4902 participants, mean age was 72.6 ± 5.4 years, median YAL for males was 8.8 (interquartile range [IQR], 4.3 to 13.8) and 10.3 (IQR, 5.8 to 15.8) for females. Reductions in YAL in the fully adjusted model for females and males, respectively, were: -1.34 (95% confidence interval [CI], -2.18, -0.49) and -1.41 (95% CI, -2.03, -0.8) for abnormal left ventricular (LV) ejection fraction, -0.5 (95% CI, -0.78, -0.22) and -0.62 (95% CI, -0.87, -0.36) per SD increase in LV mass, -0.5 (95% CI, -0.7, -0.29) and -0.79 (95% CI, -0.99, -0.58) for IMT, -0.5 (95% CI, -0.64, -0.37) and -0.79 (95% CI, -0.94, -0.65) for N-terminal pro-brain natriuretic peptide, -1.08 (95% CI, -1.34, -0.83) and -0.73 (95% CI, -0.97, -0.5) for high-sensitivity troponin-T, and -0.26 (95% CI, -0.42, -0.09) and -0.23 (95% CI, -0.41, -0.05) for procollagen-III N-terminal propeptide. Most tested variables remained significant even after adjusting for incident cardiovascular (CV) disease.</p><p><b>CONCLUSIONS: </b>In this population-based cohort, variables obtained by CV imaging and biomarkers of inflammation, coagulation, atherosclerosis, myocardial injury and stress, and cardiac collagen turnover were associated with YAL, an important outcome that integrates physical ability and longevity in older persons.</p> |
| DOI | 10.1161/JAHA.114.001745 |
| Alternate Journal | J Am Heart Assoc |
| PubMed ID | 25907126 |
| PubMed Central ID | PMC4579951 |
| Grant List | AG023629 / AG / NIA NIH HHS / United States HHSN268200800007C / / PHS HHS / United States HHSN268201200036C / / PHS HHS / United States HL080295 / HL / NHLBI NIH HHS / United States K01 AG039387 / AG / NIA NIH HHS / United States N01 HC55222 / HC / NHLBI NIH HHS / United States N01HC85079 / HC / NHLBI NIH HHS / United States N01HC85080 / HC / NHLBI NIH HHS / United States N01HC85081 / HC / NHLBI NIH HHS / United States N01HC85082 / HC / NHLBI NIH HHS / United States N01HC85083 / HC / NHLBI NIH HHS / United States N01HC85086 / HC / NHLBI NIH HHS / United States P30 ES005605 / ES / NIEHS NIH HHS / United States |