Impact of Modifiable Risk Factors on B-type Natriuretic Peptide and Cardiac Troponin T Concentrations

Abstract

Alcohol use, physical activity, diet, and cigarette smoking are modifiable cardiovascular risk factors that have a substantial impact on the risk of myocardial infarction, stroke, and cardiovascular death. We hypothesized that these behaviors may alter concentrations of cardiac troponin, a marker of myocyte injury, and B-type natriuretic peptide, a marker of myocyte stress. Both markers have shown strong association with adverse cardiovascular outcomes. In 519 women with no evidence of cardiovascular disease, we measured circulating concentrations of cardiac troponin T, using a high-sensitivity assay (hsTnT), and the N-terminal fragment of B-type natriuretic peptide (NT-proBNP). We used logistic regression to determine if these behaviors were associated with hsTnT ≥ 3 ng/l or with NT-proBNP in the highest quartile (≥ 127.3 ng/l). The median (Q1 to Q3) NT-proBNP of the cohort was 68.8 ng/l (40.3 to 127.3 ng/l), and 30.8% (160 of 519) of the cohort had circulating hsTnT ≥ 3 ng/l. In adjusted models, women who drank 1 to 6 drinks/week had lower odds of having a hsTnT ≥ 3 ng/l (odds ratio 0.58, 95% confidence interval 0.34 to 0.96) and lower odds of having an elevated NT-proBNP (odds ratio 0.55, 95% confidence interval 0.32 to 0.96). We were subsequently able to validate the results for B-type natriuretic peptide in a large independent cohort. In conclusion, our results suggest that regular alcohol consumption is associated with lower concentrations of hsTnT and NT-proBNP, 2 cardiovascular biomarkers associated with cardiovascular risk, and raise the hypothesis that the beneficial effects of alcohol consumption may be mediated by direct effects on the myocardium.

Figure 1

Modifiable Risk Factors (A: Alcohol, B: Smoking, C: Leisure Time Physical Activity, D: Alternative Healthy Eating Index-2010 Score,) and the Odds of Having an Elevated NT-proBNP Concentration(●) or a Detectable Cardiac Troponin T (■). Models adjusted for age, body mass index, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, history of hypertension, triglycerides, postmenopausal status, estimated glomerular filtration rate, physical activity, alcohol use, smoking status, Alternative Healthy Eating Index-2010 score. Abbreviations: MET, Metabolic Equivalent; NT-proBNP, N-terminal pro-B-type Natriuretic Peptide; hsTnT, High-Sensitivity Cardiac Troponin T.