High-Sensitivity Cardiac Troponin T and Cognitive Function Over 12 Months After Stroke-Results of the DEMDAS Study
Regina von Rennenberg, Christian H Nolte, Thomas G Liman, Simon Hellwig, Christoph Riegler, Jan F Scheitz, Marios K Georgakis, Rong Fang, Felix J Bode, Gabor C Petzold, Peter Hermann, Inga Zerr, Michael Goertler, Kathleen Bernkopf, Silke Wunderlich, Martin Dichgans, Matthias Endres, DEMDAS investigators *, Matthias Endres, Thomas G Liman, Lucia Kerti, Christian H Nolte, Tatjana Wittenberg, Jan F Scheitz, Harald Prüß, Pia Sophie Sperber, Alexander H Nave, Anna Kufner Ibaroule, Gabor Petzold, Felix Bode, Sebastian Stösser, Julius Meissner, Taraneh Ebrahimi, Julia Nordsiek, Niklas Beckonert, Christine Kindler, Inga Zerr, Peter Hermann, Matthias Schmitz, Stefan Goebel, Timothy Bunck, Julia Schütte-Schmidt, Sabine Nuhn, Corinna Volpers, Peter Dechent, Mathias Bähr, Michael Görtler, Wenzel Glanz, Valentina Perosa, Martin Dichgans, Frank Wollenweber, Rong Fang, Daniel Janowitz, Karin Waegemann, Steffen Tiedt, Silke Wunderlich, Benno Ikenberg, Kathleen Bernkopf, Christiane Huber, Holger Poppert, Marco Düring, Miguel Ángel Araque Caballero, Benno Gieserich, Anna Dewenter, Laura Dobisch, Katja Neumann, Oliver Speck, Annika Spottke, Tony Stöcker, Peter Bartenstein, Michael Wagner, Regina von Rennenberg, Christian H Nolte, Thomas G Liman, Simon Hellwig, Christoph Riegler, Jan F Scheitz, Marios K Georgakis, Rong Fang, Felix J Bode, Gabor C Petzold, Peter Hermann, Inga Zerr, Michael Goertler, Kathleen Bernkopf, Silke Wunderlich, Martin Dichgans, Matthias Endres, DEMDAS investigators *, Matthias Endres, Thomas G Liman, Lucia Kerti, Christian H Nolte, Tatjana Wittenberg, Jan F Scheitz, Harald Prüß, Pia Sophie Sperber, Alexander H Nave, Anna Kufner Ibaroule, Gabor Petzold, Felix Bode, Sebastian Stösser, Julius Meissner, Taraneh Ebrahimi, Julia Nordsiek, Niklas Beckonert, Christine Kindler, Inga Zerr, Peter Hermann, Matthias Schmitz, Stefan Goebel, Timothy Bunck, Julia Schütte-Schmidt, Sabine Nuhn, Corinna Volpers, Peter Dechent, Mathias Bähr, Michael Görtler, Wenzel Glanz, Valentina Perosa, Martin Dichgans, Frank Wollenweber, Rong Fang, Daniel Janowitz, Karin Waegemann, Steffen Tiedt, Silke Wunderlich, Benno Ikenberg, Kathleen Bernkopf, Christiane Huber, Holger Poppert, Marco Düring, Miguel Ángel Araque Caballero, Benno Gieserich, Anna Dewenter, Laura Dobisch, Katja Neumann, Oliver Speck, Annika Spottke, Tony Stöcker, Peter Bartenstein, Michael Wagner
Abstract
Background: Subclinical myocardial injury in form of hs-cTn (high-sensitivity cardiac troponin) levels has been associated with cognitive impairment and imaging markers of cerebral small vessel disease (SVD) in population-based and cardiovascular cohorts. Whether hs-cTn is associated with domain-specific cognitive decline and SVD burden in patients with stroke remains unknown.
Methods and results: We analyzed patients with acute stroke without premorbid dementia from the prospective multicenter DEMDAS (DZNE [German Center for Neurodegenerative Disease]-Mechanisms of Dementia after Stroke) study. Patients underwent neuropsychological testing 6 and 12 months after the index event. Test results were classified into 5 cognitive domains (language, memory, executive function, attention, and visuospatial function). SVD markers (lacunes, cerebral microbleeds, white matter hyperintensities, and enlarged perivascular spaces) were assessed on cranial magnetic resonance imaging to constitute a global SVD score. We examined the association between hs-cTnT (hs-cTn T levels) and cognitive domains as well as the global SVD score and individual SVD markers, respectively. Measurement of cognitive and SVD-marker analyses were performed in 385 and 466 patients with available hs-cTnT levels, respectively. In analyses adjusted for demographic characteristics, cardiovascular risk factors, and cognitive status at baseline, higher hs-cTnT was negatively associated with the cognitive domains "attention" up to 12 months of follow-up (beta-coefficient, -0.273 [95% CI, -0.436 to -0.109]) and "executive function" after 12 months. Higher hs-cTnT was associated with the global SVD score (adjusted odds ratio, 1.95 [95% CI, 1.27-3.00]) and the white matter hyperintensities and lacune subscores.
Conclusions: In patients with stroke, hs-cTnT is associated with a higher burden of SVD markers and cognitive function in domains linked to vascular cognitive impairment.
Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01334749.
Keywords: acute stroke; cardiac troponin; cognitive impairment; heart and brain axis.
Source: PubMed