title: High-sensitivity cardiac troponin T is associated with cognitive decline in older adults at high cardiovascular risk.
abstract: 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).
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Department of Gerontology and Geriatrics, Leiden University Medical Center, the Netherlands.
authors.forename: Liselotte W
authors.initials: LW
authors.lastname: Wijsman
authors.affiliation: Department of Gerontology and Geriatrics, Leiden University Medical Center, the Netherlands.
authors.forename: Anton Jm
authors.initials: AJ
authors.lastname: de Craen
authors.affiliation: Department of Gerontology and Geriatrics, Leiden University Medical Center, the Netherlands Department of Cardiology, Leiden University Medical Center, the Netherlands.
authors.forename: Stella
authors.initials: S
authors.lastname: Trompet
authors.affiliation: Department of Gerontology and Geriatrics, Leiden University Medical Center, the Netherlands Department of Radiology, Leiden University Medical Center, the Netherlands.
authors.forename: Behnam
authors.initials: B
authors.lastname: Sabayan
authors.affiliation: Department of Gerontology and Geriatrics, Leiden University Medical Center, the Netherlands.
authors.forename: Majon
authors.initials: M
authors.lastname: Muller
authors.affiliation: Academic Section of Geriatrics, University of Glasgow, UK.
authors.forename: David J
authors.initials: DJ
authors.lastname: Stott
authors.affiliation: Robertson Center for Biostatistics, University of Glasgow, UK.
authors.forename: Ian
authors.initials: I
authors.lastname: Ford
authors.affiliation: British Heart Foundation, University of Glasgow, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Welsh
authors.affiliation: Department of Public Health and Center for Healthy Aging, University of Copenhagen, Denmark.
authors.forename: Rudi Gj
authors.initials: RG
authors.lastname: Westendorp
authors.affiliation: Department of Cardiology, Leiden University Medical Center, the Netherlands.
authors.forename: J Wouter
authors.initials: JW
authors.lastname: Jukema
authors.affiliation: British Heart Foundation, University of Glasgow, UK Naveed.Sattar@glasgow.ac.uk.
authors.forename: Naveed
authors.initials: N
authors.lastname: Sattar
authors.affiliation: Department of Gerontology and Geriatrics, Leiden University Medical Center, the Netherlands Institute for Evidence-Based Medicine in Old Age, the Netherlands.
authors.forename: Simon P
authors.initials: SP
authors.lastname: Mooijaart
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood* / Q000150:complications / Q000517:prevention & control; D003071:Cognition / Q000502:physiology*; D060825:Cognitive Dysfunction / Q000097:blood* / Q000209:etiology / Q000503:physiopathology; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008297:Male; D017035:Pravastatin / Q000627:therapeutic use*; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D020107:Troponin T; D017035:Pravastatin
keywords: Cardiac troponin T; N-terminal pro-brain natriuretic peptide; cardiovascular diseases; cognition