Table 2.
Association between quintiles of normalized biomarker concentrations and the risk of heart failure
| Biomarker | Events | Unadjusted | Model 1: Demographica Adjusted | Model 2: Model 1+ACR+eGFR | Model 3: Model 2+CVD Risk Factorsb |
|---|---|---|---|---|---|
| KIM-1/Cr, ng/g | |||||
| ≤661 | 29 (10) | Ref | Ref | Ref | Ref |
| >661–1112 | 52 (19) | 1.84 (1.17 to 2.90) | 1.88 (1.19 to 2.96) | 1.38 (0.87 to 2.19) | 1.35 (0.84 to 2.18) |
| >1112–1831 | 56 (21) | 2.05 (1.31 to 3.21) | 2.11 (1.34 to 3.31) | 1.30 (0.82 to 2.07) | 1.11 (0.69 to 1.81) |
| >1831–2990 | 85 (33) | 3.26 (2.14 to 4.97) | 3.25 (2.12 to 4.99) | 1.64 (1.04 to 2.57) | 1.63 (1.02 to 2.60) |
| >2990 | 111 (50) | 4.87 (3.24 to 7.34) | 4.80 (3.15 to 7.31) | 1.72 (1.07 to 2.77) | 1.73 (1.05 to 2.85) |
| Per SD | n/a | n/a | n/a | n/a | |
| NGAL/Cr, mcg/g | |||||
| ≤2.63 | 37 (13) | Ref | Ref | Ref | Ref |
| >2.63–8.40 | 52 (19) | 1.47 (0.96 to 2.24) | 1.37 (0.90 to 2.10) | 1.09 (0.71 to 1.66) | 1.11 (0.72 to 1.71) |
| >8.4–20.2 | 55 (20) | 1.56 (1.03 to 2.36) | 1.39 (0.91 to 2.12) | 0.81 (0.52 to 1.25) | 0.81 (0.52 to 1.26) |
| >20.2–64.07 | 80 (32) | 2.41 (1.63 to 3.56) | 2.27 (1.52 to 3.40) | 0.87 (0.56 to 1.36) | 0.91 (0.58 to 1.42) |
| >64.07 | 109 (48) | 3.62 (2.49 to 5.26) | 3.57 (2.41 to 5.30) | 0.87 (0.54 to 1.40) | 0.99 (0.61 to 1.61) |
| Per SD | 1.54 (1.39 to 1.71) | 1.53 (1.37 to 1.71) | 0.91 (0.78 to 1.05) | 0.97 (0.83 to 1.13) | |
| L-FABP/Cr, mcg/g | |||||
| Undetectable | 32 (14) | Ref | Ref | Ref | Ref |
| Below LLD | 47 (18) | 1.27 (0.81 to 1.99) | 1.30 (0.83 to 2.04) | 1.11 (0.71 to 1.74) | 1.15 (0.73 to 1.83) |
| <9.68 | 54 (19) | 1.19 (0.76 to 1.85) | 1.18 (0.75 to 1.85) | 0.97 (0.62 to 1.52) | 0.95 (0.60 to 1.52) |
| ≥9.68–<33.8 | 80 (29) | 2.38 (1.59 to 3.57) | 2.29 (1.52 to 3.45) | 1.17 (0.76 to 1.78) | 1.16 (0.75 to 1.80) |
| ≥33.8 | 120 (48) | 3.33 (2.25 to 4.93) | 3.30 (2.20 to 4.95) | 1.01 (0.64 to 1.59) | 1.03 (0.64 to 1.66) |
| Per SD | n/p | n/p | n/p | n/p | |
| NAG/Cr, U/g | |||||
| ≤2.08 | 37 (13) | Ref | Ref | Ref | Ref |
| >2.08–3.33 | 45 (16) | 1.25 (0.81 to 1.93) | 1.14 (0.74 to 1.77) | 0.80 (0.51 to 1.25) | 0.77 (0.48 to 1.23) |
| >3.33–4.96 | 48 (18) | 1.38 (0.90 to 2.11) | 1.25 (0.81 to 1.93) | 0.64 (0.41 to 1.02) | 0.68 (0.42 to 1.09) |
| >4.96–8.36 | 84 (34) | 2.62 (1.78 to 3.86) | 2.45 (1.65 to 3.64) | 0.96 (0.61 to 1.49) | 1.02 (0.65 to 1.62) |
| >8.36 | 119 (53) | 4.08 (2.82 to 5.90) | 3.80 (2.59 to 5.56) | 1.09 (0.67 to 1.76) | 1.06 (0.64 to 1.75) |
| Per SD | n/a | n/a | n/a | n/a | |
Data are frequency (rate per 1000 person-yr) or HR (95% confidence interval). ACR, albumin-to-creatinine ratio; CVD, cardiovascular disease; KIM-1, kidney injury molecule-1; Cr, urinary creatinine; Ref, reference group; n/a, not applicable; NGAL, neutrophil gelatinase-associated lipocalin; L-FABP, liver fatty acid-binding protein; LLD, lower limit of detection; n/p, not possible; NAG, N-acetyl-β-d-glucosaminidase.
Demographic adjusted: age, sex, race/ethnicity, and clinical center.
CVD risk factors: diabetes mellitus, smoking, baseline CVD, systolic and diastolic BP, body mass index, LDL, HDL, angiotensin-converting enzyme inhibitor, angiotensin receptor blocker, statin, antiplatelet agents, and aldosterone antagonists. KIM-1/Cr and NAG/Cr relationships with heart failure events were not well described by the linear analysis and were better described by splines, thus per SD results are not reported. Because of the many undetectable values of L-FABP/Cr, continuous analyses are unable to be computed and are not reported.