Cardiovascular biomarkers and subclinical brain disease in the atherosclerosis risk in communities study.
Cardiovascular biomarkers and subclinical brain disease in the atherosclerosis risk in communities study.
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DOI：
10.1161/strokeaha.113.001128
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发表时间：
2013-07
期刊：
影响因子：
8.3
通讯作者：
Ballantyne CM
中科院分区：
文献类型：
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作者：
Dadu RT;Fornage M;Virani SS;Nambi V;Hoogeveen RC;Boerwinkle E;Alonso A;Gottesman RF;Mosley TH;Ballantyne CM
脑血管和心血管疾病有共同的危险因素。我们的目标是确定在动脉粥样硬化风险社区（ARIC）研究中，通过高灵敏度测定（hs-cTnT）测量的N-末端脑钠肽（NT-proBNP）和心肌肌钙蛋白T水平是否与磁共振成像（MRI）上的无症状脑梗死（BI）和白色病变（WML）相关。1920名参与者在ARIC访视3（1993-1995）时接受了脑部MRI检查。在ARIC访视4（1996-1998）时测量所有个体的NT-proBNP和hs-cTnT。在1920人中，1112人在2004-2006年进行了随访MRI。我们分析了无心力衰竭、冠心病或卒中的受试者中NT-proBNP和hs-cTnT与初始MRI上MRI定义的BI和WML以及随访MRI上事件BI和WML进展的相关性。在调整后的模型中，NT-proBNP最高四分位数的个体具有显著更多的BI（比值比[OR] 3.50，95%置信区间[CI]2.03-6.20）和WML（β系数0.09[标准误]（SE）0.03]）基线MRI和更多事件BI（OR 2.18，95% CI [1.38-3.47]）和随访MRI上的WML进展（β系数0.22（SE 0.10））。hs-cTnT类别最高的个体在初始MRI上有更多的BI（OR 3.03，95% CI [1.57-5.82]）和WML（β系数0.11 [SE 0.04]），在随访MRI上有更多的WML进展（β系数0.43 [0.17]）。NT-proBNP和hs-cTnT与MRI定义的无症状BI和WML独立相关，表明心血管生物标志物可能有助于识别亚临床脑损伤患者。
Cerebrovascular and cardiovascular disease share common risk factors. Our goal was to determine if levels of N-terminal brain natriuretic peptide (NT-proBNP) and cardiac troponin T measured with a highly sensitive assay (hs-cTnT) are associated with silent brain infarcts (BI) and white matter lesions (WML) on magnetic resonance imaging (MRI) in the Atherosclerosis Risk In Communities (ARIC) study. 1920 participants had brain MRI at ARIC visit 3 (1993–1995). NT-proBNP and hs-cTnT were measured in all individuals at ARIC visit 4 (1996-1998). Of 1920 individuals, 1112 had a follow-up MRI in 2004-2006. We analyzed the association of NT-proBNP and hs-cTnT with MRI-defined BI and WML on the initial MRI and incident BI and WML progression on the follow-up MRI in participants without heart failure, coronary heart disease, or stroke. In the adjusted model, individuals in the highest NT-proBNP quartile had significantly more BI (odds ratio [OR] 3.50, 95% confidence interval [CI]2.03-6.20) and WML (β-coefficient 0.09[standard error](SE) 0.03]) on the baseline MRI and more incident BI (OR 2.18, 95% CI [1.38-3.47]) and WML progression (β-coefficient 0.22 (SE 0.10)] on the follow-up MRI. Individuals in the highest hs-cTnT category had more BI (OR 3.03, 95% CI [1.57-5.82) and WML (β-coefficient 0.11 [SE 0.04]) on the initial MRI and more WML progression (β-coefficient 0.43 [0.17]) on the follow-up MRI. NT-proBNP and hs-cTnT are independently associated with silent MRI-defined BI and WML suggesting that cardiovascular biomarkers may be useful to identify individuals with subclinical cerebral injury.