Abstract P413: Association Between High Sensitivity Troponin T and N-Terminal Pro B-Type Natriuretic Peptide and Fall Risk in Older Adult Participants of the Atherosclerosis Risk in Communities Study (ARIC)

Abstract

Background: Many health practitioners worry that treating cardiovascular disease (CVD) risk factors (e.g. blood pressure) could contribute to falls in older adults. While prior CVD is a known risk factor for falls, it is unknown whether subclinical measures of myocardial injury and wall stress are related to falls among older adults without known CVD. Hypothesis: Markers of subclinical CVD, i.e. high sensitivity troponin T (hs-cTNT) and N-terminal pro b-type natriuretic peptide (NT-proBNP), are associated with new falls among older adults without known CVD. Methods: We examined the prospective association between hs-cTNT and NT-proBNP assessed at visit 5 (2011-2013) in ARIC participants who did not have a history of coronary heart disease, stroke, or heart failure. Falls were identified from hospital discharge ICD-9 codes or CMS claims. We determined fall incidence rates across the following categories approximating quartiles of hs-cTNT (<8, 8-10, 11-16, ≥17 ng/L) and NT-proBNP (<75, 75-124, 125-274, ≥275 pg/mL) via Poisson models adjusted for age, sex, and race. The relative risk between markers and fall risk was modelled via Cox models adjusted for demographic characteristics and fall risk factors. Results: In 4,303 participants (mean age 76 ± 5 yrs, 63% women, 24% black), there were 429 new falls during a median follow-up of 4.5 years. Incidence rates across categories of hs-cTNT were 10.9, 16.0, 18.9, and 26.5 per 1,000 person-years; and incidence rates across categories of NT-proBNP were 8.1, 15.6, 21.5, and 33.0 per 1,000 person-years. Hs-cTNT ≥17 vs <8 ng/L was significantly associated with a higher risk of falls (adjusted HR 2.22, 95%CI 1.56-3.18). Similarly, NT-proBNP ≥275 vs <75 pg/mL was significantly associated with a higher risk of falls (2.46; 1.72-3.51). Associations with fall risk were curvilinear for both markers ( Figure ). Conclusions: Subclinical CVD was associated with risk of falls in older adults. Further research is needed to delineate mechanisms by which subclinical CVD might contribute to falls.