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Associations between inflammation, coagulation, cardiac strain and injury, and subclinical vascular disease with frailty in older men: a cross-sectional study

Douglas G. J. McKechnie, Meera Patel, A. Olia Papacosta, Lucy T. Lennon, Libby Ellins Orcid Logo, Julian Halcox Orcid Logo, Sheena E. Ramsay, Peter H. Whincup, S. Goya Wannamethee

BMC Geriatrics, Volume: 22, Issue: 1

Swansea University Authors: Libby Ellins Orcid Logo, Julian Halcox Orcid Logo

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Abstract

BackgroundInflammation, coagulation activation, endothelial dysfunction and subclinical vascular disease are cross-sectionally associated with frailty. Cardiac-specific biomarkers are less-well characterised. We assessed associations between these and frailty, in men with, and without, cardiovascula...

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Published in: BMC Geriatrics
ISSN: 1471-2318
Published: Springer Science and Business Media LLC 2022
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Cardiac-specific biomarkers are less-well characterised. We assessed associations between these and frailty, in men with, and without, cardiovascular disease (CVD).MethodsCross-sectional analysis of 1096 men without, and 303 with, CVD, aged 71&#x2013;92, from the British Regional Heart Study. Multinominal logistic regression was performed to examine the associations between frailty status (robust/pre-frail/frail) and, separately, C-reactive protein (CRP), interleukin-6 (IL-6), tissue plasminogen activator (tPA), D-dimer, von Willebrand factor (vWF), high-sensitivity cardiac troponin-T (hs-cTnT), N-terminal pro B-type natriuretic peptide (NT-proBNP) (all natural log-transformed), and, in men without CVD, carotid intima-media thickness (CIMT), carotid-femoral pulse wave velocity (cfPWV), carotid distensibility coefficient (DC), and ankle-brachial pressure index (ABPI), adjusted for age, renal function, BMI, social class, smoking, polypharmacy, cognition, multimorbidity and systolic blood pressure. Explanatory variables with p &lt;&#x2009;0.05 were carried forward into mutually-adjusted analysis.ResultsIn men without CVD, higher CRP, IL-6, vWF, tPA, hs-cTnT, NT-proBNP, cfPWV, and lower DC were significantly associated with frailty; mutually-adjusted, log IL-6 (OR for frailty&#x2009;=&#x2009;2.02, 95%CI 1.38&#x2013;2.95), log hs-cTnT (OR&#x2009;=&#x2009;1.95, 95%CI 1.24&#x2013;3.05) and DC (OR&#x2009;=&#x2009;0.92, 95%CI 0.86&#x2013;0.99) retained associations. In men with CVD, higher CRP, IL-6, and hs-cTnT, but not vWF, tPA, NT-proBNP or D-dimer, were significantly associated with frailty; mutually-adjusted, log hs-cTnT (OR 3.82, 95%CI 1.84&#x2013;7.95) retained a significant association.ConclusionsIn older men, biomarkers of myocardial injury are associated with frailty. Inflammation is associated with frailty in men without CVD. Carotid artery stiffness is associated with frailty in men without CVD, independently of these biomarkers.</abstract><type>Journal Article</type><journal>BMC Geriatrics</journal><volume>22</volume><journalNumber>1</journalNumber><paginationStart/><paginationEnd/><publisher>Springer Science and Business Media LLC</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic>1471-2318</issnElectronic><keywords>Frailty, Biomarkers, Cardiovascular diseases, Aging, Atherosclerosis</keywords><publishedDay>9</publishedDay><publishedMonth>5</publishedMonth><publishedYear>2022</publishedYear><publishedDate>2022-05-09</publishedDate><doi>10.1186/s12877-022-03106-3</doi><url/><notes/><college>COLLEGE NANME</college><department>Health Data Science</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>HDAT</DepartmentCode><institution>Swansea University</institution><apcterm>External research funder(s) paid the OA fee (includes OA grants disbursed by the Library)</apcterm><funders>This work was supported by the British Heart Foundation (grant nos. RG/19/4/34452 and PG/09/024/26857).</funders><lastEdited>2022-06-07T11:24:55.5449458</lastEdited><Created>2022-04-28T10:44:27.5674356</Created><path><level id="1">Swansea University Medical School</level><level id="2">Medicine</level></path><authors><author><firstname>Douglas G. J.</firstname><surname>McKechnie</surname><order>1</order></author><author><firstname>Meera</firstname><surname>Patel</surname><order>2</order></author><author><firstname>A. Olia</firstname><surname>Papacosta</surname><order>3</order></author><author><firstname>Lucy T.</firstname><surname>Lennon</surname><order>4</order></author><author><firstname>Libby</firstname><surname>Ellins</surname><orcid>0000-0001-5164-6416</orcid><order>5</order></author><author><firstname>Julian</firstname><surname>Halcox</surname><orcid>0000-0001-6926-2947</orcid><order>6</order></author><author><firstname>Sheena E.</firstname><surname>Ramsay</surname><order>7</order></author><author><firstname>Peter H.</firstname><surname>Whincup</surname><order>8</order></author><author><firstname>S. Goya</firstname><surname>Wannamethee</surname><order>9</order></author></authors><documents><document><filename>59916__24241__8faafcfa856e45c2b6b33e36d635b840.pdf</filename><originalFilename>59916.pdf</originalFilename><uploaded>2022-06-07T11:14:53.7547629</uploaded><type>Output</type><contentLength>783305</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>&#xA9; The Author(s) 2022. This article is licensed under a Creative Commons Attribution 4.0 International License</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language><licence>http://creativecommons.org/licenses/by/4.0/</licence></document></documents><OutputDurs/></rfc1807>
spelling 2022-06-07T11:24:55.5449458 v2 59916 2022-04-28 Associations between inflammation, coagulation, cardiac strain and injury, and subclinical vascular disease with frailty in older men: a cross-sectional study 553ce2abe05a6396e7dd6eadb6b90a6d 0000-0001-5164-6416 Libby Ellins Libby Ellins true false 3676f695eeda169d0f8c618adf27c04b 0000-0001-6926-2947 Julian Halcox Julian Halcox true false 2022-04-28 HDAT BackgroundInflammation, coagulation activation, endothelial dysfunction and subclinical vascular disease are cross-sectionally associated with frailty. Cardiac-specific biomarkers are less-well characterised. We assessed associations between these and frailty, in men with, and without, cardiovascular disease (CVD).MethodsCross-sectional analysis of 1096 men without, and 303 with, CVD, aged 71–92, from the British Regional Heart Study. Multinominal logistic regression was performed to examine the associations between frailty status (robust/pre-frail/frail) and, separately, C-reactive protein (CRP), interleukin-6 (IL-6), tissue plasminogen activator (tPA), D-dimer, von Willebrand factor (vWF), high-sensitivity cardiac troponin-T (hs-cTnT), N-terminal pro B-type natriuretic peptide (NT-proBNP) (all natural log-transformed), and, in men without CVD, carotid intima-media thickness (CIMT), carotid-femoral pulse wave velocity (cfPWV), carotid distensibility coefficient (DC), and ankle-brachial pressure index (ABPI), adjusted for age, renal function, BMI, social class, smoking, polypharmacy, cognition, multimorbidity and systolic blood pressure. Explanatory variables with p < 0.05 were carried forward into mutually-adjusted analysis.ResultsIn men without CVD, higher CRP, IL-6, vWF, tPA, hs-cTnT, NT-proBNP, cfPWV, and lower DC were significantly associated with frailty; mutually-adjusted, log IL-6 (OR for frailty = 2.02, 95%CI 1.38–2.95), log hs-cTnT (OR = 1.95, 95%CI 1.24–3.05) and DC (OR = 0.92, 95%CI 0.86–0.99) retained associations. In men with CVD, higher CRP, IL-6, and hs-cTnT, but not vWF, tPA, NT-proBNP or D-dimer, were significantly associated with frailty; mutually-adjusted, log hs-cTnT (OR 3.82, 95%CI 1.84–7.95) retained a significant association.ConclusionsIn older men, biomarkers of myocardial injury are associated with frailty. Inflammation is associated with frailty in men without CVD. Carotid artery stiffness is associated with frailty in men without CVD, independently of these biomarkers. Journal Article BMC Geriatrics 22 1 Springer Science and Business Media LLC 1471-2318 Frailty, Biomarkers, Cardiovascular diseases, Aging, Atherosclerosis 9 5 2022 2022-05-09 10.1186/s12877-022-03106-3 COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University External research funder(s) paid the OA fee (includes OA grants disbursed by the Library) This work was supported by the British Heart Foundation (grant nos. RG/19/4/34452 and PG/09/024/26857). 2022-06-07T11:24:55.5449458 2022-04-28T10:44:27.5674356 Swansea University Medical School Medicine Douglas G. J. McKechnie 1 Meera Patel 2 A. Olia Papacosta 3 Lucy T. Lennon 4 Libby Ellins 0000-0001-5164-6416 5 Julian Halcox 0000-0001-6926-2947 6 Sheena E. Ramsay 7 Peter H. Whincup 8 S. Goya Wannamethee 9 59916__24241__8faafcfa856e45c2b6b33e36d635b840.pdf 59916.pdf 2022-06-07T11:14:53.7547629 Output 783305 application/pdf Version of Record true © The Author(s) 2022. This article is licensed under a Creative Commons Attribution 4.0 International License true eng http://creativecommons.org/licenses/by/4.0/
title Associations between inflammation, coagulation, cardiac strain and injury, and subclinical vascular disease with frailty in older men: a cross-sectional study
spellingShingle Associations between inflammation, coagulation, cardiac strain and injury, and subclinical vascular disease with frailty in older men: a cross-sectional study
Libby Ellins
Julian Halcox
title_short Associations between inflammation, coagulation, cardiac strain and injury, and subclinical vascular disease with frailty in older men: a cross-sectional study
title_full Associations between inflammation, coagulation, cardiac strain and injury, and subclinical vascular disease with frailty in older men: a cross-sectional study
title_fullStr Associations between inflammation, coagulation, cardiac strain and injury, and subclinical vascular disease with frailty in older men: a cross-sectional study
title_full_unstemmed Associations between inflammation, coagulation, cardiac strain and injury, and subclinical vascular disease with frailty in older men: a cross-sectional study
title_sort Associations between inflammation, coagulation, cardiac strain and injury, and subclinical vascular disease with frailty in older men: a cross-sectional study
author_id_str_mv 553ce2abe05a6396e7dd6eadb6b90a6d
3676f695eeda169d0f8c618adf27c04b
author_id_fullname_str_mv 553ce2abe05a6396e7dd6eadb6b90a6d_***_Libby Ellins
3676f695eeda169d0f8c618adf27c04b_***_Julian Halcox
author Libby Ellins
Julian Halcox
author2 Douglas G. J. McKechnie
Meera Patel
A. Olia Papacosta
Lucy T. Lennon
Libby Ellins
Julian Halcox
Sheena E. Ramsay
Peter H. Whincup
S. Goya Wannamethee
format Journal article
container_title BMC Geriatrics
container_volume 22
container_issue 1
publishDate 2022
institution Swansea University
issn 1471-2318
doi_str_mv 10.1186/s12877-022-03106-3
publisher Springer Science and Business Media LLC
college_str Swansea University Medical School
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hierarchy_top_id swanseauniversitymedicalschool
hierarchy_top_title Swansea University Medical School
hierarchy_parent_id swanseauniversitymedicalschool
hierarchy_parent_title Swansea University Medical School
department_str Medicine{{{_:::_}}}Swansea University Medical School{{{_:::_}}}Medicine
document_store_str 1
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description BackgroundInflammation, coagulation activation, endothelial dysfunction and subclinical vascular disease are cross-sectionally associated with frailty. Cardiac-specific biomarkers are less-well characterised. We assessed associations between these and frailty, in men with, and without, cardiovascular disease (CVD).MethodsCross-sectional analysis of 1096 men without, and 303 with, CVD, aged 71–92, from the British Regional Heart Study. Multinominal logistic regression was performed to examine the associations between frailty status (robust/pre-frail/frail) and, separately, C-reactive protein (CRP), interleukin-6 (IL-6), tissue plasminogen activator (tPA), D-dimer, von Willebrand factor (vWF), high-sensitivity cardiac troponin-T (hs-cTnT), N-terminal pro B-type natriuretic peptide (NT-proBNP) (all natural log-transformed), and, in men without CVD, carotid intima-media thickness (CIMT), carotid-femoral pulse wave velocity (cfPWV), carotid distensibility coefficient (DC), and ankle-brachial pressure index (ABPI), adjusted for age, renal function, BMI, social class, smoking, polypharmacy, cognition, multimorbidity and systolic blood pressure. Explanatory variables with p < 0.05 were carried forward into mutually-adjusted analysis.ResultsIn men without CVD, higher CRP, IL-6, vWF, tPA, hs-cTnT, NT-proBNP, cfPWV, and lower DC were significantly associated with frailty; mutually-adjusted, log IL-6 (OR for frailty = 2.02, 95%CI 1.38–2.95), log hs-cTnT (OR = 1.95, 95%CI 1.24–3.05) and DC (OR = 0.92, 95%CI 0.86–0.99) retained associations. In men with CVD, higher CRP, IL-6, and hs-cTnT, but not vWF, tPA, NT-proBNP or D-dimer, were significantly associated with frailty; mutually-adjusted, log hs-cTnT (OR 3.82, 95%CI 1.84–7.95) retained a significant association.ConclusionsIn older men, biomarkers of myocardial injury are associated with frailty. Inflammation is associated with frailty in men without CVD. Carotid artery stiffness is associated with frailty in men without CVD, independently of these biomarkers.
published_date 2022-05-09T04:17:25Z
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