High-Sensitivity Cardiac Troponin T and Cognitive Function Over 12 Months After Stroke-Results of the DEMDAS Study.

Journal: Journal of the American Heart Association

Volume: 13

Issue: 6

Year of Publication: 2024

Affiliated Institutions:  Department of Neurology (Klinik und Hochschulambulanz für Neurologie) Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin Berlin Germany. Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Munich Germany. Division of Vascular Neurology, Department of Neurology University Hospital Bonn Bonn Germany. German Center for Neurodegenerative Diseases (DZNE) Göttingen Göttingen Germany. Department of Neurology Magdeburg University Vascular and Stroke Centre Magdeburg Germany. Department of Neurology, School of Medicine Klinikum rechts der Isar, Technical University of Munich Munich Germany.

Abstract summary 

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.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.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.URL: https://www.clinicaltrials.gov; Unique identifier: NCT01334749.

Authors & Co-authors:  von Rennenberg Nolte Liman Hellwig Riegler Scheitz Georgakis Fang Bode Petzold Hermann Zerr Goertler Bernkopf Wunderlich Dichgans Endres

Study Outcome 

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Statistics
Citations : 
Authors :  18
Identifiers
Doi : 10.1161/JAHA.123.033439
SSN : 2047-9980
Study Population
Male,Female
Mesh Terms
Humans
Other Terms
acute stroke;cardiac troponin;cognitive impairment;heart and brain axis
Study Design
Study Approach
Country of Study
Publication Country
England