Table 4.
Association of Cardiac Biomarkers With Incident Decline in KCCQ Scoresa, Among Participants With Year 1 KCCQ ≥75 (N=2132)
| Incident Decline in KCCQa Model 0 HR (99% CI) | Incident Decline in KCCQ Model 1 aHR (99% CI) | Incident Decline in KCCQ Model 2 aHR (99% CI) | |
|---|---|---|---|
| GDF‐15 continuous model | 1.67 (1.45, 1.92)b | 1.57 (1.35, 1.83)b | 1.36 (1.12, 1.65)b |
| Log(GDF‐15) per 1 SD (0.58 pg/mL) increase | |||
| GDF‐15 categorical model | 1.0 (Ref.) | 1.0 (Ref.) | 1.0 (Ref.) |
| Quintile 1 (≤856 pg/mL) | |||
| Quintile 2 (857–1200 pg/mL) | 2.06 (1.23, 3.44)b | 1.89 (1.12, 3.20)b | 1.63 (0.94, 2.83) |
| Quintile 3 (1201–1570 pg/mL) | 2.33 (1.39, 3.90)b | 2.08 (1.23, 3.53)b | 1.59 (0.89, 2.83) |
| Quintile 4 (1571–2220 pg/mL) | 3.77 (2.30, 6.18)b | 3.28 (1.94, 5.53)b | 2.34 (1.27, 4.30)b |
| Quintile 5 (>2220 pg/mL) | 5.28 (3.23, 8.63)b | 4.55 (2.70, 7.68)b | 3.15 (1.68, 5.89)b |
| Galectin‐3 continuous model | 1.36 (1.17, 1.58)b | 1.22 (1.05, 1.42)b | 1.08 (0.92, 1.26) |
| Log(Galectin‐3) per 1 SD (0.50 pg/mL) increase | |||
| Galectin‐3 categorical model | 1.0 (Ref.) | 1.0 (Ref.) | 1.0 (Ref.) |
| Quintile 1 (≤9.11 pg/mL) | |||
| Quintile 2 (9.12–12.2 pg/mL) | 1.53 (0.96, 2.45) | 1.42 (0.89, 2.28) | 1.33 (0.83, 2.15) |
| Quintile 3 (12.3–15.4 pg/mL) | 1.84 (1.16, 2.91)b | 1.61 (1.02, 2.56)b | 1.43 (0.90, 2.28) |
| Quintile 4 (15.5–20.1 pg/mL) | 2.26 (1.44, 3.55)b | 1.84 (1.17, 2.91)b | 1.46 (0.91, 2.33) |
| Quintile 5 (>20.1 pg/mL) | 2.79 (1.76, 4.42)b | 2.08 (1.29, 3.34)b | 1.50 (0.92, 2.46) |
| sST‐2 continuous model | 1.11 (0.96, 1.29) | 1.16 (0.99, 1.35) | 1.08 (0.92, 1.26) |
| Log(sST‐2) per 1 SD (0.55 pg/mL) increase | |||
| sST‐2 categorical model | 1.0 (Ref.) | 1.0 (Ref.) | 1.0 (Ref.) |
| Quintile 1 (≤10.4 pg/mL) | |||
| Quintile 2 (10.5–13.4 pg/mL) | 1.13 (0.74, 1.73) | 1.15 (0.75, 1.77) | 1.02 (0.66, 1.58) |
| Quintile 3 (13.5–16.8 pg/mL) | 1.00 (0.64, 1.56) | 1.00 (0.64, 1.57) | 0.90 (0.57, 1.41) |
| Quintile 4 (16.9–22 pg/mL) | 1.16 (0.75, 1.78) | 1.22 (0.78, 1.91) | 0.97 (0.61, 1.53) |
| Quintile 5 (> 22 pg/mL) | 1.51 (1.00, 2.29)b | 1.77 (1.15, 2.73)b | 1.46 (0.93, 2.28) |
| hsTnT continuous model | 1.42 (1.24, 1.62)b | 1.44 (1.24, 1.68)b | 1.20 (1.01, 1.44)b |
| Log(hsTnT) per 1 SD (0.78 ng/L) increase | |||
| hsTnT categorical model | 1.0 (Ref.) | 1.0 (Ref.) | 1.0 (Ref.) |
| < lower limit of detection (<10 ng/L) | |||
| Tertile 1 (10.1–14.7 ng/L) | 1.51 (1.03, 2.23)b | 1.56 (1.05, 2.32)b | 1.34 (0.89, 2.02) |
| Tertile 2 (14.8–23.9 ng/L) | 1.81 (1.25, 2.64)b | 1.86 (1.25, 2.79)b | 1.40 (0.92, 2.14) |
| Tertile 3 (>23.9 ng/L) | 2.52 (1.74, 3.65)b | 2.67 (1.76, 4.04)b | 1.75 (1.10, 2.80)b |
| NT‐proBNP continuous model | 1.59 (1.37, 1.85)b | 1.51 (1.29, 1.76)b | 1.30 (1.08, 1.56)b |
| Log(NT‐proBNP) per 1 SD (1.60 pg/mL) increase | |||
| NT‐proBNP categorical model | 1.0 (Ref.) | 1.0 (Ref.) | 1.0 (Ref.) |
| Quintile 1 (≤31.9 pg/mL) | |||
| Quintile 2 (31–76 pg/mL) | 1.64 (1.01, 2.67)b | 1.51 (0.93, 2.46) | 1.31 (0.79, 2.15) |
| Quintile 3 (76.1–158 pg/mL) | 1.57 (0.95, 2.58) | 1.42 (0.86, 2.37) | 1.12 (0.66, 1.88) |
| Quintile 4 (158.1–370 pg/mL) | 2.73 (1.72, 4.32)b | 2.47 (1.54, 3.98)b | 1.75 (1.05, 2.92)b |
| Quintile 5 (>370 pg/mL) | 3.48 (2.19, 5.55)b | 2.89 (1.78, 4.69)b | 1.88 (1.09, 3.24)b |
Model 0: Unadjusted; Model 1: Age, sex, race/ethnicity; Model 2: M1 + myocardial infarction, chronic obstructive pulmonary disease, atrial fibrillation, stroke, diabetes mellitus, systolic blood pressure, body mass index, current smoking, estimated glomerular filtration rate, 24 h urinary protein, angiotensin‐converting enzyme inhibitosr/angiotensin receptor blockers, diuretics, and beta blocker use; aHR indicates adjusted hazard ratio; GDF‐15, growth differentiation factor‐15; HR, hazard ratio; hsTnT, high‐sensitivity troponin T; KCCQ, Kansas City Cardiomyopathy Questionnaire; NT‐proBNP, N‐terminal pro‐B‐type natriuretic peptide; and sST‐2, soluble suppression of tumorigenesis‐2.
Incident decline in KCCQ defined as participants with KCCQ≥75 developing a KCCQ<75 and having an average decline in KCCQ score of >3 points/y.
P<0.01.