High‐Sensitivity Cardiac Troponin T and Cognitive Function Over 12 Months After Stroke—Results of the DEMDAS Study
Authors: von Rennenberg Regina , Nolte Christian H. , Liman Thomas G. , Hellwig Simon , Riegler Christoph , Scheitz Jan F. , Georgakis Marios K. , Fang Rong , Bode Felix J. , Petzold Gabor C. , Hermann Peter , Zerr Inga , Goertler Michael , Bernkopf Kathleen , Wunderlich Silke , Dichgans Martin , Endres Matthias , Endres Matthias , Liman Thomas G. , Kerti Lucia , Nolte Christian H. , Wittenberg Tatjana , Scheitz Jan F. , Prüß Harald , Sperber Pia Sophie , Nave Alexander H. , Ibaroule Anna Kufner , Petzold Gabor , Bode Felix , Stösser Sebastian , Meissner Julius , Ebrahimi Taraneh , Nordsiek Julia , Beckonert Niklas , Kindler Christine , Zerr Inga , Hermann Peter , Schmitz Matthias , Goebel Stefan , Bunck Timothy , Schütte‐Schmidt Julia , Nuhn Sabine , Volpers Corinna , Dechent Peter , Bähr Mathias , Görtler Michael , Glanz Wenzel , Perosa Valentina , Dichgans Martin , Wollenweber Frank , Fang Rong , Janowitz Daniel , Waegemann Karin , Tiedt Steffen , Wunderlich Silke , Ikenberg Benno , Bernkopf Kathleen , Huber Christiane , Poppert Holger , Düring Marco , Araque Caballero Miguel Ángel , Gieserich Benno , Dewenter Anna , Dobisch Laura , Neumann Katja , Speck Oliver , Spottke Annika , Stöcker Tony , Bartenstein Peter , Wagner Michael 
Published: March 2024

Background

Subclinical myocardial injury in form of hs‐cTn (high‐sensitivity cardiac troponin)  levels has been associated with cognitive impairment and imaging markers of cerebral small vessel disease (SVD) in population‐based and cardiovascular cohorts. Whether hs‐cTn is associated with domain‐specific cognitive decline and SVD burden in patients with stroke remains unknown.

Methods and Results

We analyzed patients with acute stroke without premorbid dementia from the prospective multicenter DEMDAS (DZNE [German Center for Neurodegenerative Disease]‐Mechanisms of Dementia after Stroke) study. Patients underwent neuropsychological testing 6 and 12 months after the index event. Test results were classified into 5 cognitive domains (language, memory, executive function, attention, and visuospatial function). SVD markers (lacunes, cerebral microbleeds, white matter hyperintensities, and enlarged perivascular spaces) were assessed on cranial magnetic resonance imaging to constitute a global SVD score. We examined the association between hs‐cTnT (hs‐cTn T levels) and cognitive domains as well as the global SVD score and individual SVD markers, respectively. Measurement of cognitive and SVD‐marker analyses were performed in 385 and 466 patients with available hs‐cTnT levels, respectively. In analyses adjusted for demographic characteristics, cardiovascular risk factors, and cognitive status at baseline, higher hs‐cTnT was negatively associated with the cognitive domains “attention” up to 12 months of follow‐up (beta‐coefficient, −0.273 [95% CI, −0.436 to −0.109]) and “executive function” after 12 months. Higher hs‐cTnT was associated with the global SVD score (adjusted odds ratio, 1.95 [95% CI, 1.27–3.00]) and the white matter hyperintensities and lacune subscores.

Conclusions

In patients with stroke, hs‐cTnT is associated with a higher burden of SVD markers and cognitive function in domains linked to vascular cognitive impairment.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT01334749.