A prospective assessment of cardiac biomarkers for hemodynamic stress and necrosis and the risk of falls among older people: the ActiFE study
A prospective assessment of cardiac biomarkers for hemodynamic stress and necrosis and the risk of falls among older people: the ActiFE study
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DOI：
10.1007/s10654-015-0059-9
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发表时间：
2016-04-01
影响因子：
13.6
通讯作者：
Rothenbacher, Dietrich
中科院分区：
文献类型：
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作者：
Dallmeier, Dhayana;Klenk, Jochen;Rothenbacher, Dietrich
跌倒与各种危险因素的复杂相互作用有关。我们研究了血液动力学应激（n端前脑利钠肽- nt - probnp）和坏死（高敏感（hs）心肌肌钙蛋白T （cTnT）和I (cTnI)）的心脏生物标志物是否与老年人跌倒有关。在1506名社区居住成年人的队列中，以每千分之一的比例测量了65年的基线生物标志物。前瞻性评估跌倒时间（中位数370天）。cox比例风险模型评估了每个生物标志物与首次跌倒发生率的关联，并考虑了已确定的混杂因素。我们观察到1327名参与者中有430例事件下降，所有生物标志物的效果都因性别而改变。在男性的多变量分析中，对数转换hs-cTnI的一个单位增量与1.26的风险比（HR）相关（95% CI 1.04, 1.53）。与检测不到hs-cTnT水平的男性相比，hs-cTnT水平为千分之一14 ng/L的男性的风险比为1.74（95%可信区间1.15,2.61）。在女性中，cTn与跌倒无关。我们没有发现NT-proBNP与跌倒风险之间的关联。我们的研究结果表明，心肌肌钙蛋白不仅可以识别有心血管疾病风险的受试者，还有助于了解跌倒的潜在复杂病理生理。
Falls are related to a complex interaction of risk factors. We examined if cardiac biomarkers for hemodynamic stress (N-terminal pro Brain Natriuretic Peptide-NT-proBNP), and for necrosis [high sensitive (hs) cardiac troponins T (cTnT) and I (cTnI)] are associated with falls in older people. Biomarkers were measured at baseline in a cohort of 1506 community-dwelling adults a parts per thousand yen65 years. Falls were assessed prospectively in a falls calendar (median 370 days). Cox-proportional hazards models evaluated the association of each biomarker with the incidence of the first fall accounting for established confounders. We observed 430 incident falls among 1327 participants and an effect modification by sex for all biomarkers. In multivariable analyses among men a one unit increment of log-transformed hs-cTnI was associated with a hazard ratio (HR) of 1.26 (95 % CI 1.04, 1.53). Men with hs-cTnT a parts per thousand yen 14 ng/L had a HR of 1.74 (95 % CI 1.15, 2.61) compared to those with undetectable hs-cTnT levels. In women cTn were not associated with falls. We did not detect an association between NT-proBNP and the risk of fall. Our results suggest that cardiac troponins may not only identify subjects at risk for cardiovascular diseases, but also help to understand the underlying complex pathophysiology of falls.