Evidence map›Paper›PMID 32943164›Full record

SynthesisJournal of the American College of Cardiology2020

Sex-Specific Associations of Cardiovascular Risk Factors and Biomarkers With Incident Heart Failure.

Navin Suthahar, Emily S Lau, Michael J Blaha, Samantha M Paniagua, Martin G Larson, Bruce M Psaty, Emelia J Benjamin, Matthew A Allison, Traci M Bartz, James L Januzzi and 20 more

Open access · hybridAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of the American College of Cardiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 63 papers.

0numbers the graph read from it
0cells of the map it votes in
63citing papers in PubMed
8.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

63 citing papers in PubMed, 101 citations in OpenAlex.

  1. Trial
  2. Article
  3. Cardiac Biomarkers in Chronic Kidney Disease: Signal or Noise?Clinical journal of the American Society of Nephrology : CJASN · 2026
    Review
  4. Review
  5. Article
  6. Review
  7. Article
  8. Review
  9. Article
  10. Review
  11. Review
  12. Review
  13. Review
  14. Review
  15. Article
  16. Article
  17. Article
  18. Article
  19. Sex-based Differences in Heart Failure Biomarkers.Current heart failure reports · 2024
    Review
  20. Article

3 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

30 authors at 18 institutions in 3 countries.

Navin SuthaharDepartment of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Emily S LauCardiology Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
Michael J BlahaCiccarone Center for the Prevention of Heart Disease, The Johns Hopkins University, Baltimore, Maryland.
Samantha M PaniaguaCardiology Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
Martin G LarsonDepartment of Biostatistics, Boston University School of Public Health, Boston, Massachusetts; Boston University School of Medicine and School of Public Health, and NHLBI and Boston University's Framingham Heart Study, Framingham, Massachusetts.
Bruce M PsatyDepartments of Medicine, Epidemiology and Health Services, University of Washington, and Kaiser Permanente Washington Health Research Institute, Seattle, Washington.
Emelia J BenjaminBoston University School of Medicine and School of Public Health, and NHLBI and Boston University's Framingham Heart Study, Framingham, Massachusetts.
Matthew A AllisonDepartment of Family Medicine and Public Health, University of California, San Diego, La Jolla, California.
Traci M BartzDepartment of Biostatistics, University of Washington, Seattle, Washington.
James L JanuzziCardiology Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
Daniel LevyBoston University School of Medicine and School of Public Health, and NHLBI and Boston University's Framingham Heart Study, Framingham, Massachusetts; Center for Population Studies, National Heart, Lung, and Blood Institute, Bethesda, Maryland.
Laura M G MeemsDepartment of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Stephan J L BakkerDepartment of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Joao A C LimaDepartment of Medicine, Johns Hopkins Medical Institutions, and Department of Cardiology, Heart and Vascular Institute, The Johns Hopkins University, Baltimore, Maryland.
Mary CushmanDepartment of Medicine and Pathology & Laboratory Medicine, University of Vermont Larner College of Medicine, Burlington, Vermont.
Douglas S LeeDepartment of Medicine and Pathology & Laboratory Medicine, University of Vermont Larner College of Medicine, Burlington, Vermont; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada.
Thomas J WangDepartment of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas.
Christopher R deFilippiInova Heart and Vascular Institute, Falls Church, Virginia.
David M HerringtonSection on Cardiovascular Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina.
Matthew NayorCardiology Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
Ramachandran S VasanBoston University School of Medicine and School of Public Health, and NHLBI and Boston University's Framingham Heart Study, Framingham, Massachusetts.
Julius M GardinDivision of Cardiology, Department of Medicine, Rutgers New Jersey Medical School, Newark, New Jersey.
Jorge R KizerDepartments of Medicine, Epidemiology and Biostatistics, San Francisco Veterans Affairs Health Care System and University of California-San Francisco, San Francisco, California.
Alain G BertoniDivision of Public Health Sciences, Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina.
Norrina B AllenDepartment of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Ron T GansevoortDepartment of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Sanjiv J ShahDivision of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
John S GottdienerInova Heart and Vascular Institute, Falls Church, Virginia.
Jennifer E HoCardiology Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts. Electronic address: jho1@mgh.harvard.edu.
Rudolf A de BoerDepartment of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. Electronic address: r.a.de.boer@umcg.nl.
Harvard University · USAlaska Heart and Vascular Institute · USBoston University · USFramingham Heart Study · USJohns Hopkins University · USNorthwestern University · USUniversity Medical Center Groningen · NLUniversity of Groningen · NLWake Forest University · USInstitute for Clinical Evaluative Sciences · CAKaiser Permanente Washington Health Research Institute · USMassachusetts General Hospital · USRutgers, The State University of New Jersey · USSouthwestern Medical CenterSouthwestern Medical Center · USUniversity of California, San Diego · USUniversity of Vermont · USUniversity of Washington · US

Funding

Institute for Clinical and Translational ResearchUL1TR001079 · NCATS · JOHNS HOPKINS UNIVERSITY · PI FORD, DANIEL ERNEST · 2013 to 2017
$60.1M
Wake Forest Clinical and Translational Science AwardUL1TR001420 · NCATS · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI ARD, JAMY D, FOLEY, KRISTIE L · 2015 to 2023
$32.3M
Clinical and Translational Science AwardUL1TR000040 · NCATS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI GINSBERG, HENRY N · 2012 to 2015
$26.2M
IDENTIFICATION OF COMMON GENETIC VARIANTS FOR ATRIAL FIBRILLATION AND PR INTERVALR01HL092577 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI BENJAMIN, EMELIA J., ELLINOR, PATRICK THOMAS · 2009 to 2025
$20.6M
Task Area A Core Study Operations.Task Area A shall encompass annual follow-up of cohort members, clinical endpoints ascertainment, study coordination activities, maintenance of the database and biosp75N92020D00001 · NHLBI · UNIVERSITY OF WASHINGTON · PI MCCLELLAND, ROBYN LEAGH · 2020 to 2025
$17.2M
Exceptional Survival: Trajectories to Functional Aging (CHS All Stars)R01AG023629 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI NEWMAN, ANNE B. · 2004 to 2016
$9.5M
Noninvasive Cardiovascular Imaging Research Training ProgramT32HL094301 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI Marcelo F DI CARLI · 2010 to 2026
$7.8M
CHS research resources for the cardiovascular health of older adultsU01HL130114 · NHLBI · UNIVERSITY OF WASHINGTON · PI BURKE, GREGORY L, KRONMAL, RICHARD A · 2016 to 2019
$6.6M
Transition from Risk Factors to Early HF: Prevalence, Pathogenesis, and PhenomicsR01HL127028 · NHLBI · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI BERTONI, ALAIN GERALD, SHAH, SANJIV J · 2015 to 2018
$6.5M
Task Area A shall encompass annual follow-up of cohort members, clinical events investigations, study operations, and data analysis and manuscript writing. If implemented, Task A.1 will provide fundin75N92020D00005 · NHLBI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI WATSON, KAROL E · 2020 to 2025
$5.1M
CHS Events Follow-up StudyU01HL080295 · NHLBI · UNIVERSITY OF WASHINGTON · PI PSATY, BRUCE M · 2005 to 2008
$4.6M
TO EXERCISE OPTION PERIOD ONE (1) FOR TASK AREA A - MESA CORE OPERATIONS, FIELD CENTER.75N92020D00004 · NHLBI · NORTHWESTERN UNIVERSITY · PI SIEGEL, JONATHAN H · 2020 to 2025
$4.5M
NCATS NIH HHS UL1 TR000040NCATS NIH HHS UL1 TR001079NCATS NIH HHS UL1 TR001420NHLBI NIH HHS 75N92020D00001NHLBI NIH HHS 75N92020D00002NHLBI NIH HHS 75N92020D00003NHLBI NIH HHS 75N92020D00004NHLBI NIH HHS 75N92020D00005NHLBI NIH HHS 75N92020D00006NHLBI NIH HHS 75N92020D00007NHLBI NIH HHS HHSN268200800007CNHLBI NIH HHS HHSN268201200036CNHLBI NIH HHS HHSN268201500001CNHLBI NIH HHS HHSN268201500001INHLBI NIH HHS HHSN268201500003CNHLBI NIH HHS HHSN268201500003INHLBI NIH HHS HHSN268201800001CNHLBI NIH HHS K23 HL138260NHLBI NIH HHS N01 HC025195NHLBI NIH HHS N01 HC055222NHLBI NIH HHS N01 HC085079NHLBI NIH HHS N01 HC085080NHLBI NIH HHS N01 HC085081NHLBI NIH HHS N01 HC085082NHLBI NIH HHS N01 HC085083NHLBI NIH HHS N01 HC085086NHLBI NIH HHS N01 HC095159NHLBI NIH HHS N01 HC095160NHLBI NIH HHS N01 HC095161NHLBI NIH HHS N01 HC095162NHLBI NIH HHS N01 HC095163NHLBI NIH HHS N01 HC095164NHLBI NIH HHS N01 HC095165NHLBI NIH HHS N01 HC095166NHLBI NIH HHS N01 HC095167NHLBI NIH HHS N01 HC095168NHLBI NIH HHS N01 HC095169NHLBI NIH HHS N01HC55222NHLBI NIH HHS N01HC85079NHLBI NIH HHS N01HC85080NHLBI NIH HHS N01HC85081NHLBI NIH HHS N01HC85082NHLBI NIH HHS N01HC85083NHLBI NIH HHS N01HC85086NHLBI NIH HHS R01 HL092577NHLBI NIH HHS R01 HL107577NHLBI NIH HHS R01 HL127028NHLBI NIH HHS R01 HL128914NHLBI NIH HHS R01 HL134893NHLBI NIH HHS R01 HL140224NHLBI NIH HHS R01 HL140731NHLBI NIH HHS R01 HL149423NHLBI NIH HHS T32 HL094301NHLBI NIH HHS U01 HL080295NHLBI NIH HHS U01 HL130114NIA NIH HHS R01 AG023629
6 · The paper itself

Abstract

backgroundWhether cardiovascular (CV) disease risk factors and biomarkers associate differentially with heart failure (HF) risk in men and women is unclear.

objectivesThe purpose of this study was to evaluate sex-specific associations of CV risk factors and biomarkers with incident HF.

methodsThe analysis was performed using data from 4 community-based cohorts with 12.5 years of follow-up. Participants (recruited between 1989 and 2002) were free of HF at baseline. Biomarker measurements included natriuretic peptides, cardiac troponins, plasminogen activator inhibitor-1, D-dimer, fibrinogen, C-reactive protein, sST2, galectin-3, cystatin-C, and urinary albumin-to-creatinine ratio.

resultsAmong 22,756 participants (mean age 60 ± 13 years, 53% women), HF occurred in 2,095 participants (47% women). Age, smoking, type 2 diabetes mellitus, hypertension, body mass index, atrial fibrillation, myocardial infarction, left ventricular hypertrophy, and left bundle branch block were strongly associated with HF in both sexes (p < 0.001), and the combined clinical model had good discrimination in men (C-statistic = 0.80) and in women (C-statistic = 0.83). The majority of biomarkers were strongly and similarly associated with HF in both sexes. The clinical model improved modestly after adding natriuretic peptides in men (ΔC-statistic = 0.006; likelihood ratio chi-square = 146; p < 0.001), and after adding cardiac troponins in women (ΔC-statistic = 0.003; likelihood ratio chi-square = 73; p < 0.001).

conclusionsCV risk factors are strongly and similarly associated with incident HF in both sexes, highlighting the similar importance of risk factor control in reducing HF risk in the community. There are subtle sex-related differences in the predictive value of individual biomarkers, but the overall improvement in HF risk estimation when included in a clinical HF risk prediction model is limited in both sexes.

Indexed as

Sex CharacteristicsAgedBiomarkersCohort StudiesFemaleHeart FailureHumansIncidenceMaleMiddle AgedNetherlandsRisk FactorsUnited StatesBiomarkersbiomarkersheart failurepredictive valuerisk factorssex differences

Identifiers

PMID32943164
PMCPMC7493711
OpenAlexW3084752132

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.