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

Research output: Contribution to journalJournal articleResearchpeer-review

Liselotte W Wijsman, Anton JM de Craen, Stella Trompet, Behnam Sabayan, Majon Muller, David J Stott, Ian Ford, Paul Welsh, Rudi GJ Westendorp, J Wouter Jukema, Naveed Sattar, Simon P Mooijaart

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.

Original languageEnglish
JournalEuropean Journal of Preventive Cardiology
Volume23
Issue number13
Pages (from-to)1383-1392
Number of pages10
ISSN2047-4873
DOIs
Publication statusPublished - Sep 2016

ID: 160192170