High-sensitivity cardiac troponin T is associated with cognitive decline in older adults at high cardiovascular risk

Wijsman, L. W. et al. (2016) High-sensitivity cardiac troponin T is associated with cognitive decline in older adults at high cardiovascular risk. European Journal of Preventive Cardiology, 23(13), pp. 1383-1392. (doi: 10.1177/2047487316632364) (PMID:26884081)

Abstract

Aims: Cardiac troponin T (cTnT), measured with a high-sensitivity (hs) assay, is associated with cognitive decline, but the underlying mechanism is unknown. We investigated the association of hs-cTnT with cognitive function and decline, and studied whether this association was independent of cardiovascular diseases or risk factors, and N-terminal pro-brain natriuretic peptide (NT-proBNP). Methods and results: We studied 5407 participants (mean age 75.31 years) from the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER), who all had cardiovascular diseases or risk factors thereof. Participants with pre-existent advanced clinical heart failure were excluded. Hs-cTnT and NT-proBNP obtained after 6 months of follow-up were related with cognitive function, tested repeatedly during a mean follow-up of 3.2 years. Participants with higher hs-cTnT performed worse at baseline on Stroop test (mean baseline score (standard error (SE)) lowest vs highest third 65.91 (1.16) vs 69.40 (1.10) seconds, p < 0.001), Letter–Digit Coding test (23.35 (0.32) vs 22.40 (0.31) digits coded, p < 0.001), immediate Picture–Word Learning test (9.45 (0.09) vs 9.31 (0.08) pictures remembered, p = 0.002) and delayed Picture–Word Learning test (10.33 (0.12) vs 10.10 (0.12) pictures remembered, p = 0.013). Furthermore, participants with higher hs-cTnT had steeper decline on Stroop test (mean annual change (SE) lowest vs highest third 0.34 (0.12) vs 1.06 (0.12) seconds, p = 0.013), Letter–Digit Coding test (–0.29 (0.03) vs −0.46 (0.03) digits coded, p < 0.001), immediate Picture–Word Learning test (0.01 (0.01) vs −0.06 (0.01) pictures remembered, p < 0.001) and delayed Picture–Word Learning test (–0.03 (0.01) vs −0.12 (0.02) pictures remembered, p = 0.001). Associations were independent of cardiovascular diseases risk factors or Apolipoprotein E genotype. Further adjusting for NT-proBNP levels revealed the same results. Conclusions: Higher levels of hs-cTnT associate with worse cognitive function and steeper cognitive decline in older adults independent of cardiovascular diseases, risk factors and NT-proBNP.

• Item Type: Articles
• Additional Information: The original PROSPER clinical trial was funded by an investigator-initiated grant from Bristol-Myers Squibb, USA.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Welsh, Professor Paul and Stott J, Professor David and Ford, Professor Ian and Sattar, Professor Naveed
• Authors: Wijsman, L. W., de Craen, A. J.M., Trompet, S., Sabayan, B., Muller, M., Stott, D. J., Ford, I., Welsh, P., Westendorp, R. G.J., Jukema, J. W., Sattar, N., and Mooijaart, S. P.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
• Journal Name: European Journal of Preventive Cardiology
• Publisher: SAGE Publications
• ISSN: 2047-4873
• ISSN (Online): 2047-4881
• Published Online: 16 February 2016
• Copyright Holders: Copyright © 2016 The European Society of Cardiology
• First Published: First published in European Journal of Preventive Cardiology 23(13): 1383-1392
• Publisher Policy: Reproduced in accordance with the publisher copyright policy