title: High-sensitivity cardiac troponin I and NT-proBNP as predictors of incident dementia and Alzheimer's disease: the FINRISK Study.
abstract: Cardiac troponin and N-terminal pro-brain natriuretic peptide (NT-proBNP) are known to associate with incident dementia. The purpose of our study was to examine whether high-sensitivity cardiac troponin I (hs-TnI) and NT-proBNP are associated with incident dementia and Alzheimer's disease (AD) independently of each other. Our study was a part of the national population-based health examination survey, FINRISK 1997, with a total sample of 7114 subjects, including 407 incident dementia cases and 319 AD cases during the follow-up time of 18 years. Using multivariate Cox regression analyses, we calculated the hazard ratios (HR) for hs-TnI and NT-proBNP. Analyses were adjusted for the previously known dementia/AD risk factors, including the apoE genotype. NT-proBNP was independently associated with incident dementia (HR 1.32, 95% CI 1.17-1.49) and AD (HR 1.30, 95% CI 1.13-1.5). Hs-TnI was also associated with incident dementia (HR 1.12, 95% CI 1.02-1.23), but not independent of NT-proBNP (HR 1.10, 95% CI 0.99-1.21). Hs-TnI was not associated with incident AD. The results remained similar in cause-specific Cox regression models and among subjects over 40 years of age. NT-proBNP and hs-TnI improved the reclassification of dementia risk in 10 years follow-up, and hs-TNI also in 18 years of follow-up. Neither hs-TnI nor NT-proBNP was able to outperform each other in risk reclassification of dementia. Both cardiovascular biomarkers, NT-proBNP and hs-TnI, were associated with incident dementia independently of traditional dementia risk factors including the apoE genotype. NT-proBNP was also associated with AD. Both markers offered a better dementia risk reclassification compared with traditional risk factors.
authors.affiliation: Tampere University, Tampere, Finland. juho.tynkkynen@gmail.com.|, Sammonkatu 29 B 34, 33540, Tampere, Finland. juho.tynkkynen@gmail.com.
authors.forename: Juho
authors.identifier: http://orcid.org/0000-0001-9882-9180
authors.initials: J
authors.lastname: Tynkkynen
authors.affiliation: Tampere University, Tampere, Finland.
authors.forename: Jussi A
authors.initials: JA
authors.lastname: Hernesniemi
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland.|Institute of Public Health and Clinical Nutrition, university of Eastern Finland, Kuopio, Finland.|Hospital District of North Karelia, Joensuu, Finland.
authors.forename: Tiina
authors.initials: T
authors.lastname: Laatikainen
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Aki S
authors.initials: AS
authors.lastname: Havulinna
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Perttu
authors.initials: P
authors.lastname: Salo
authors.affiliation: Clinic for General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany.|Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Partner Site Hamburg/Lübeck/Kiel, Hamburg, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Blankenberg
authors.affiliation: Clinic for General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany.|Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Partner Site Hamburg/Lübeck/Kiel, Hamburg, Germany.
authors.forename: Tanja
authors.initials: T
authors.lastname: Zeller
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Veikko
authors.initials: V
authors.lastname: Salomaa
mesh_terms: D000328:Adult; D000368:Aged; D001057:Apolipoproteins E / Q000235:genetics; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D002784:Cholesterol / Q000097:blood; D003704:Dementia / Q000097:blood* / Q000453:epidemiology / Q000235:genetics; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D016016:Proportional Hazards Models; D012307:Risk Factors; D011795:Surveys and Questionnaires; D019210:Troponin I / Q000097:blood*
chemical_list: D001057:Apolipoproteins E; D015415:Biomarkers; D010446:Peptide Fragments; D019210:Troponin I; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002784:Cholesterol
keywords: Alzheimer’s disease; Apo E genotype; Cardiac troponin I; Dementia; NT-proBNP; Population based; Prospective