Cardiac biomarkers and subsequent risk of hospitalization with bleeding in the community: Atherosclerosis risk in communities study

Lena Mathews, Junichi Ishigami, Ning Ding, Ron C. Hoogeveen, Anna Kucharska-Newton, Christie M. Ballantyne, Rebecca Gottesman, Elizabeth Selvin, Kunihiro Matsushita

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Background-—hs-cTnT (high-sensitivity cardiac troponin T), but not NT-proBNP (N-terminal pro–B natriuretic peptide), has been shown to predict bleeding in patients with atrial fibrillation. Whether these biomarkers are independently associated with bleeding in the general population is unknown. Methods and Results-—We used Cox proportional hazards models to examine the association of hs-cTnT and NT-proBNP with incident bleeding (defined by International Classification of Diseases, Ninth Revision [ICD-9] codes) among 9550 middle-aged men and women without a history of cardiovascular disease or bleeding. There were 847 hospitalizations with bleeding (92% from gastrointestinal bleeding) during a median follow-up of 9.0 years. Serum levels of hs-cTnT were associated with bleeding in a graded fashion, with a hazard ratio of 1.28 (95% CI, 1.06–1.59) for 6 to <9 ng/L, 1.52 (1.21–1.91) for 9 to <14, and 2.05 (1.56– 2.69) for ≥14 versus <3 ng/L. For NT-proBNP, the highest category (≥264 versus <42 pg/mL) showed a hazard ratio of 2.00 (1.59–2.61), and the remaining 3 categories had hazard ratios ranging from 1.2 to 1.3. Individuals in the highest category of both hs-cTnT and NT-proBNP had a hazard ratio of 3.03 (1.97–4.68) compared with those in the lowest categories. Conclusions-—In a community-based population, elevated hs-cTnT and NT-proBNP were associated with bleeding-related hospitalizations. These biomarkers may have a high utility in identifying people at high risk for bleeding. There is a need for research on the underlying mechanisms linking subclinical cardiac abnormalities and bleeding.

Original languageEnglish
Article numbere013560
JournalJournal of the American Heart Association
Issue number5
StatePublished - 2020

Bibliographical note

Publisher Copyright:
© 2020 The Authors.


  • Bleeding
  • Cardiac troponin T
  • Gastrointestinal bleeding
  • Natriuretic peptide

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


Dive into the research topics of 'Cardiac biomarkers and subsequent risk of hospitalization with bleeding in the community: Atherosclerosis risk in communities study'. Together they form a unique fingerprint.

Cite this