Background: Animal and plant protein intakes have indicated opposite associations with cardiovascular mortality risk. Whether dietary proteins are associated with risk of heart failure (HF) is unclear. Thus, we examined the associations of proteins from different food sources with risk of HF.

Methods and Results: The study included 2441 men aged 42 to 60 years at the baseline examinations in 1984 to 1989 in the Kuopio Ischaemic Heart Disease Risk Factor Study. Protein intakes at baseline were assessed with 4-day dietary records. Data on incident HF cases were obtained from national registers. HF risk according to protein intake was estimated by Cox proportional hazard ratios. During the mean follow-up of 22.2 years, 334 incident HF cases occurred. Higher intake of total protein indicated a trend toward increased risk of HF (multivariable-adjusted hazard ratio in the highest versus lowest quartile=1.33; 95% confidence interval: 0.95–1.85; P-trend=0.05). The associations between specific types and sources of protein with incident HF were consistent with this overall finding although not all associations reached statistical significance. For example, the hazard ratio in the highest versus lowest quartile was 1.43 (95% confidence interval: 1.00–2.03; P-trend=0.07) for total animal protein and 1.17 (95% confidence interval: 0.72–1.91; P-trend=0.35) for total plant protein.

Conclusions: In middle-aged men, higher protein intake was marginally associated with increased risk of HF.

CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier: NCT03221127

背景：动植物蛋白质的摄入已表明与心血管死亡风险相反。饮食蛋白是否与心力衰竭（HF）风险相关尚不清楚。因此，我们检查了来自不同食物来源的蛋白质与HF风险的关联。

方法和结果：该研究纳入了1984年至1989年在Kuopio缺血性心脏病危险因素研究中进行的基线检查的2441名年龄在42至60岁之间的男性。基线时的蛋白质摄入量通过4天的饮食记录进行评估。从国家登记处获得有关HF事件的数据。根据Cox比例风险比估算根据蛋白质摄入量引起的HF风险。在平均22.2年的随访期间，发生了334例心力衰竭病例。总蛋白质摄入量增加表明HF风险增加趋势（最高四分位数与最低四分位数的多变量调整风险比= 1.33； 95％置信区间：0.95-1.85；P-趋势= 0.05）。尽管并非所有的关联都达到统计学意义，但特定类型和与HF入射的蛋白质来源之间的关联与这一总体发现是一致的。例如，动物总蛋白中最高四分位数与最低四分位数的风险比为1.43（95％置信区间：1.00–2.03；P-趋势= 0.07），而总动物蛋白的风险比为1.17（95％置信区间：0.72-1.91；P-趋势= 0.35）用于植物总蛋白。

结论：在中年男性中，较高的蛋白质摄入量与心衰风险增加相关。

临床试验注册： URL：https://www.clinicaltrials.gov。唯一标识符：NCT03221127