High-Sensitivity Cardiac Troponin T and Cognitive Function in Patients With Ischemic Stroke.

Abstract

Background and Purpose- Our study aim was to assess whether high-sensitivity cardiac troponin T (hs-cTnT), a specific biomarker for myocardial injury, is associated with cognitive function in patients after mild-to-moderate first-ever ischemic stroke. Methods- We used data from PROSCIS-B (Prospective Cohort With Incident Stroke Berlin). Cognitive function was assessed by Mini-Mental-State-Examination at baseline, and Telephone Interview for Cognitive Status-modified after 1 to 3 years of follow-up. Patients were categorized according to hs-cTnT quartiles. We performed generalized linear regression to calculate risk ratios of cognitive impairment (Mini-Mental-State-Examination <27; Telephone Interview for Cognitive Status-modified <32). Association of hs-cTnT with cognitive function over time was estimated using a linear mixed model. Results- We included 555 patients (mean age, 67 years, 62% male, median National Institutes of Health Stroke Scale 2 [interquartile range, 1-5], hs-cTnT above upper reference limit 40%, baseline cognitive impairment 28%). Baseline Mini-Mental-State-Examination score and rate of cognitive impairment were lower in patients in the highest versus lowest hs-cTnT quartile (median Mini-Mental-State-Examination 27 versus 29, and 15.3% versus 43.0%, adjusted risk ratio, 1.76 [95% CI, 1.07-2.90], respectively). If anything, cognition seemed to improve in all groups, yet Telephone Interview for Cognitive Status-modified scores were consistently lower in patients within the highest versus lowest hs-cTnT quartile (adjusted β, -1.33 [95% CI, -2.65 to -0.02]), without difference in the rate of change over time. Conclusions- In patients with mild-to-moderate first-ever ischemic stroke without dementia, higher hs-cTnT was associated with higher prevalence of cognitive impairment at baseline and lower Telephone Interview for Cognitive Status-modified during 3-year follow-up. Registration- URL: https://www.clinicaltrials.gov; Unique identifier: NCT01363856.

• Authors: Leonie H A Broersen, Bob Siegerink, Pia S Sperber, Regina von Rennenberg, Sophie K Piper, Christian H Nolte, Peter U Heuschmann, Matthias Endres, Jan F Scheitz, Thomas G Liman
• Journal: Stroke (Stroke) Vol. 51 Issue 5 Pg. 1604-1607 (05 2020) ISSN: 1524-4628 [Electronic] United States
• PMID: 32279621 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• TNNT2 protein, human
• Troponin T

Topics

• Adult
• Aged
• Aged, 80 and over
• Cognition
• Cognitive Dysfunction (blood, epidemiology, physiopathology, psychology)
• Female
• Follow-Up Studies
• Humans
• Linear Models
• Male
• Mental Status and Dementia Tests
• Middle Aged
• Odds Ratio
• Prevalence
• Prognosis
• Stroke (blood, physiopathology, psychology)
• Troponin T (blood)
• Young Adult