Table 3.
Association of Vital Exhaustion and Elevated Biomarkers With Incident Cardiovascular Disease Events During 10-Y Follow-Up
| Nonelevated Biomarker Levels |
Elevated Biomarker Levels |
P Value for Interactiona | |||||||
|---|---|---|---|---|---|---|---|---|---|
| Low MVEQ [Reference] | Mild MVEQ | Moderate MVEQ | Severe MVEQ | Low MVEQ | Mild MVEQ | Moderate MVEQ | Severe MVEQ | ||
| hs-TnT | 1.00 | 1.09 (0.93-1.29, P = 0.26) | 1.22 (1.04-1.43 (P = 0.01) | 1.33 (1.13-1.56, P < 0.01) | 1.65 (1.18-2.3, P < 0.01) | 1.58 (1.07-2.33, P = 0.02) | 2.37 (1.72-3.27, P < 0.01) | 2.65 (1.99-3.52, P < 0.01) | 0.52 |
| NT- proBNP |
1.00 | 1.10 (0.92-1.32, P = 0.28) | 1.27 (1.08-1.51, P < 0.01) | 1.44 (1.21-1.71, P < 0.01) | 2.37 (1.86-3.03, P < 0.01) | 2.49 (1.88-3.31, P < 0.01) | 2.89 (2.24-3.72, P < 0.01) | 2.73 (2.16-3.48, P < 0.01) | 0.59 |
| hs-CRP | 1.00 | 1.25 (0.99-1.59, P = 0.06) | 1.20 (0.95-1.52, P = 0.13) | 1.48 (1.16-1.89, P < 0.01) | 1.26 (1.03-1.54, P = 0.02) | 1.23 (0.98-1.54, P = 0.07) | 1.61 (1.31-1.99, P < 0.01) | 1.26 (1.03-1.54, P = 0.02) | 0.27 |
Values are HR (95% CI, P value). HRs were adjusted for age, sex, race, education level, current smoking status, current drinking status, body mass index, systolic and diastolic blood pressure, hypertension, diabetes status, estimated glomerular filtration rate, total cholesterol level, low-density lipoprotein cholesterol level, high-density lipoprotein cholesterol level, and lipid-lowering medication use. Cardiovascular disease events included acute myocardial infarction, coronary revascularization, ischemic stroke, and heart failure hospitalization. Symptoms of vital exhaustion were categorized as follows: 1) no symptoms (MVEQ score 0-4); 2) mild symptoms (MVEQ score 5-8); 3) moderate symptoms (MVEQ score 9-15); and severe symptoms (MVEQ score ≥16). Nonelevated biomarker levels indicate plasma levels below the following thresholds: hs-TnT <13 ng/L; NT-proBNP <125 pg/mL; hs-CRP <2 mg/L. Elevated biomarker levels indicate plasma levels above the following thresholds: hs-TnT ≥13 ng/L; NT-proBNP ≥125 pg/mL; hs-CRP ≥2 mg/L.
Abbreviations as in Table 1.
aP value for interaction between MVEQ quartiles and presence of elevated biomarker levels.