Impact of Modifiable Risk Factors on B-type Natriuretic Peptide and Cardiac Troponin T Concentrations
Pratyaksh K Srivastava1, Aruna D Pradhan2, Nancy R Cook1
1Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Insights
Moderate alcohol consumption is linked to lower levels of cardiac troponin T (hsTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP). These findings suggest potential direct cardiac benefits from regular alcohol intake.
Area of Science:
- Cardiology
- Preventive Medicine
- Biomarker Research
Background:
- Modifiable cardiovascular risk factors like alcohol use, physical activity, diet, and smoking significantly impact myocardial infarction, stroke, and cardiovascular death.
- Cardiac troponin T (hsTnT) indicates myocyte injury, while B-type natriuretic peptide (NT-proBNP) indicates myocyte stress; both are linked to adverse cardiovascular outcomes.
Purpose of the Study:
- To investigate the association between lifestyle behaviors, specifically alcohol consumption, and concentrations of hsTnT and NT-proBNP.
- To determine if modifiable risk factors influence key cardiovascular biomarkers in women without pre-existing cardiovascular disease.
Main Methods:
- A cohort of 519 women without cardiovascular disease had circulating hsTnT and NT-proBNP levels measured.
- Logistic regression analysis was employed to assess the relationship between lifestyle behaviors and elevated biomarker levels (hsTnT ≥ 3 ng/l or NT-proBNP in the highest quartile).
- Findings for NT-proBNP were validated in an independent, larger cohort.
Main Results:
- The study found that women consuming 1 to 6 drinks per week had significantly lower odds of elevated hsTnT and NT-proBNP levels.
- Adjusted models showed an odds ratio of 0.58 for hsTnT and 0.55 for NT-proBNP in moderate alcohol consumers compared to non-consumers.
- The median NT-proBNP was 68.8 ng/l, with 30.8% of the cohort exhibiting hsTnT ≥ 3 ng/l.
Conclusions:
- Regular, moderate alcohol consumption is associated with lower circulating levels of hsTnT and NT-proBNP.
- These findings suggest that alcohol may have direct beneficial effects on the myocardium, potentially mediated through these biomarkers.
- Further research is warranted to explore the mechanistic pathways linking alcohol intake to myocardial health.
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.
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