{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T17:28:10Z","timestamp":1770139690471,"version":"3.49.0"},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T00:00:00Z","timestamp":1729468800000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Both low family income and subclinical myocardial injury (SCMI) are risk factors for cardiovascular disease (CVD) mortality. However, the impact of their joint association on CVD mortality is unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This analysis from the third National Health and Nutrition Examination Survey included 6805 participants (age 59.1\u2009\u00b1\u200913.4 years, 52.3% women, and 49.8% White) free of CVD at baseline. Family income was assessed using the poverty\u2010income ratio (PIR) and categorized into low (PIR\u2009&lt;\u20091), middle (PIR\u2009=\u20091\u20134), and high (PIR\u2009&gt;\u20094) income. A validated ECG\u2010based cardiac infarction injury score (CIIS)\u2009\u2265\u200910 was considered positive for SCMI. CVD mortality was determined using the National Death Index. Cox\u2010proportional hazard analysis was used to evaluate the associations of family income and SCMI, separately and jointly, with CVD mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1782 (26.2%) participants had SCMI at baseline. During a median follow\u2010up of 18.2 years, 856 (12.6%) events of CVD mortality occurred. In separate multivariable Cox models, SCMI (vs. no SCMI) and middle\u2010 and low\u2010income (vs. high\u2010income) were each associated with a higher risk of CVD mortality (HR [95% CI]: 1.34 [1.16\u20131.54], 1.44 [1.16\u20131.78], and 1.59 [1.22\u20132.07], respectively). Compared to high\u2010income participants without SCMI, those with low\u2010income and SCMI had an increased risk of CVD mortality (HR [95% CI]: 2.17 [1.53\u20133.08]). The multiplicative interaction between PIR and SCMI was not significant (<jats:italic>p<\/jats:italic>\u2009=\u20090.054).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Lower family income and SCMI are associated with CVD mortality, and their concomitant presence is associated with the highest risk. Family income and SCMI may help in the individualized assessment of CVD risk.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.70036","type":"journal-article","created":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T09:15:32Z","timestamp":1729502132000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Association Between Family Income, Subclinical Myocardial Injury, and Cardiovascular Mortality in the General Population"],"prefix":"10.1002","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-3135-793X","authenticated-orcid":false,"given":"Sneha","family":"Chebrolu","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Wake Forest School of Medicine Winston\u2010Salem North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7085-3373","authenticated-orcid":false,"given":"Richard","family":"Kazibwe","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Wake Forest School of Medicine Winston\u2010Salem North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elsayed Z.","family":"Soliman","sequence":"additional","affiliation":[{"name":"Section on Cardiovascular Medicine, Department of Medicine, Epidemiological Cardiology Research Center (EPICARE) Wake Forest School of Medicine Winston\u2010Salem North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,10,21]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.5469"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000228"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-27474-x"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.029652"},{"key":"e_1_2_12_6_1","doi-asserted-by":"crossref","unstructured":"R. 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