High‐Sensitivity Cardiac Troponin T and Cognitive Function Over 12 Months After Stroke—Results of the DEMDAS Study
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Published:2024-03-19
Issue:6
Volume:13
Page:
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ISSN:2047-9980
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Container-title:Journal of the American Heart Association
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language:en
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Short-container-title:JAHA
Author:
von Rennenberg Regina123ORCID, Nolte Christian H.12345ORCID, Liman Thomas G.1236ORCID, Hellwig Simon125ORCID, Riegler Christoph12ORCID, Scheitz Jan F.1245ORCID, Georgakis Marios K.78ORCID, Fang Rong78ORCID, Bode Felix J.9ORCID, Petzold Gabor C.910, Hermann Peter1112ORCID, Zerr Inga1112ORCID, Goertler Michael1314, Bernkopf Kathleen15, Wunderlich Silke15, Dichgans Martin78ORCID, Endres Matthias12345ORCID, Endres Matthias, Liman Thomas G., Kerti Lucia, Nolte Christian H., Wittenberg Tatjana, Scheitz Jan F., Prüß Harald, Sperber Pia Sophie, Nave Alexander H., Ibaroule Anna Kufner, Petzold Gabor, Bode Felix, Stösser Sebastian, Meissner Julius, Ebrahimi Taraneh, Nordsiek Julia, Beckonert Niklas, Kindler Christine, Zerr Inga, Hermann Peter, Schmitz Matthias, Goebel Stefan, Bunck Timothy, Schütte‐Schmidt Julia, Nuhn Sabine, Volpers Corinna, Dechent Peter, Bähr Mathias, Görtler Michael, Glanz Wenzel, Perosa Valentina, Dichgans Martin, Wollenweber Frank, Fang Rong, Janowitz Daniel, Waegemann Karin, Tiedt Steffen, Wunderlich Silke, Ikenberg Benno, Bernkopf Kathleen, Huber Christiane, Poppert Holger, Düring Marco, Araque Caballero Miguel Ángel, Gieserich Benno, Dewenter Anna, Dobisch Laura, Neumann Katja, Speck Oliver, Spottke Annika, Stöcker Tony, Bartenstein Peter, Wagner Michael
Affiliation:
1. Department of Neurology (Klinik und Hochschulambulanz für Neurologie) Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany 2. Center for Stroke Research Berlin (CSB) Charité—Universitätsmedizin Berlin Berlin Germany 3. German Center for Neurodegenerative Diseases (Deutsches Zentrum für Neurodegenerative Erkrankungen), partner site Berlin Berlin Germany 4. German Center for Cardiovascular Research (Deutsches Zentrum für Herz‐Kreislaufforschung), partner site Berlin, Charité‐Universitätsmedizin Berlin Berlin Germany 5. Berlin Institute of Health at Charité –Universitätsmedizin Berlin, BIH Biomedical Innovation Academy Berlin Germany 6. Department of Neurology, School of Medicine and Health Sciences Carl von Ossietzky University of Oldenburg Oldenburg Germany 7. Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Munich Germany 8. German Center for Neurodegenerative Diseases (Deutsches Zentrum für Neurodegenerative Erkrankungen), partner site Munich Munich Germany 9. Division of Vascular Neurology, Department of Neurology University Hospital Bonn Bonn Germany 10. German Center for Neurodegenerative Diseases (Deutsches Zentrum für Neurodegenerative Erkrankungen), partner site Bonn Bonn Germany 11. German Center for Neurodegenerative Diseases (DZNE) Göttingen Göttingen Germany 12. Clinical Dementia Center, Department of Neurology University Medical Center Göttingen Germany 13. Department of Neurology Magdeburg University Vascular and Stroke Centre Magdeburg Germany 14. German Center for Neurodegenerative Diseases (Deutsches Zentrum für Neurodegenerative Erkrankungen), partner site Magdeburg Magdeburg Germany 15. Department of Neurology, School of Medicine Klinikum rechts der Isar, Technical University of Munich Munich Germany
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.
Publisher
Ovid Technologies (Wolters Kluwer Health)
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