Transforming growth factor beta-1 and incidence of heart failure in older adults: The Cardiovascular Health Study

Context: Transforming growth factor-betal (TGF-B1) is a highly pleiotropic cytokine whose functions include a central role in the induction of fibrosis. Objective: To investigate the hypothesis that elevated plasma levels of TGF-B1 are positively associated with incident heart failure (HF). Participants and methods: The hypotheses were tested using a two-phase case-control study design, ancillary to the Cardiovascular Health Study - a longitudinal, population-based cohort study. Cases were defined as having an incident HF event after their 1992-1993 exam and controls were free of HF at follow-up. TGF-B1 was measured using plasma collected in 1992-1993 and data from 89 cases and 128 controls were used for analysis. The association between TGF-B1 and risk of HF was evaluated using the weighted likelihood method, and odds ratios (OR) for risk of HF were calculated for TGF-B1 as a continuous linear variable and across quartiles of TGF-B1. Results: The OR for HF was 1.88 (95% confidence intervals [CI] 1.26-2.81) for each nanogram increase in TGF-B1, and the OR for the highest quartile (compared to the lowest) of TGF-B1 was 5.79 (95% CI 1.65-20.34), after adjustment for age, sex. C-reactive protein, platelet count and digoxin use. Further adjustment with other covariates did not change the results. Conclusions: Higher levels of plasma TGF-B1 were associated with an increased risk of incident heart failure among older adults. However, further study is needed in larger samples to confirm these findings. (C) 2012 Elsevier Ltd. All rights reserved.