Subclinical Myocardial Injury and Global Cognitive Performance
Background: Cognitive impairment is common in cardiovascular disease (CVD) patients. Objectives: The purpose of this study was to evaluate the relationship of myocardial injury, measured by high-sensitivity cardiac troponin T (hs-cTnT), with global cognitive performance and its decline over time. Me...
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Elsevier
2025-08-01
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| Series: | JACC: Advances |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772963X2500314X |
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| author | Shubham Tomar, MBBS, MPH Karita C.F. Lidani, MD, MSc, PhD Aline A.I. Moraes, MD, PhD Shi Huang, PhD Christian Oakley, BS Khurram Nasir, MD, MPH Michael J. Blaha, MD, MPH Susan R. Heckbert, MD, PhD Timothy M. Hughes, PhD Christopher R. deFilippi, MD Yader Sandoval, MD Allan S. Jaffe, MD Andrew P. DeFilippis, MD, MSc |
| author_facet | Shubham Tomar, MBBS, MPH Karita C.F. Lidani, MD, MSc, PhD Aline A.I. Moraes, MD, PhD Shi Huang, PhD Christian Oakley, BS Khurram Nasir, MD, MPH Michael J. Blaha, MD, MPH Susan R. Heckbert, MD, PhD Timothy M. Hughes, PhD Christopher R. deFilippi, MD Yader Sandoval, MD Allan S. Jaffe, MD Andrew P. DeFilippis, MD, MSc |
| author_sort | Shubham Tomar, MBBS, MPH |
| collection | DOAJ |
| description | Background: Cognitive impairment is common in cardiovascular disease (CVD) patients. Objectives: The purpose of this study was to evaluate the relationship of myocardial injury, measured by high-sensitivity cardiac troponin T (hs-cTnT), with global cognitive performance and its decline over time. Methods: Hs-cTnT assessed at baseline (2000-2002) and exam 5 (2010-2012) in 4,445 participants. Cognitive function evaluated using the Cognitive Abilities Screening Instrument (CASI) at exams 5 and 6 (2016-2018). Subclinical myocardial injury defined as hs-cTnT above limits of detection but below 19 ng/L, while clinical myocardial injury >19 ng/L. Cognitive decline was a >5 point decrease in CASI scores from exam 5 to 6. Regression analysis assessed the association of hs-cTnT levels with CASI scores and their decline. Results: Mean age at baseline was 60 years with 53% females. At baseline and exam 5, 63% and 87% had subclinical myocardial injury, respectively. Higher Log10(hs-cTnT) at baseline (β = −1.45 [95% CI: −2.5 to −0.41]), exam 5 (β = −1.63 [95% CI: −2.7 to −0.59]), and greater baseline to exam 5 increase (β = −1.42 [95% CI: −2.8 to −0.06]) were associated with lower CASI scores at exam 5, after adjusting for demographics, education, language, and apolipoprotein E status. These estimate lost significance after CVD risk factor adjustment. Higher Log10(hs-cTnT) at baseline (OR: 2.02 [95% CI: 1.29-3.12]), exam 5 (OR: 2.52 [95% CI: 1.56-4.05]), or greater baseline to exam 5 increase (OR: 2.22 [95% CI: 1.18-4.15]) were associated with higher odds of cognitive decline in fully adjusted models. Conclusions: In community-based cohort, higher or increasing hs-cTnT was associated with greater odds of future cognitive decline over 6 years of follow-up. |
| format | Article |
| id | doaj-art-a4433be9b935448c8e389151ffd60b5e |
| institution | Kabale University |
| issn | 2772-963X |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JACC: Advances |
| spelling | doaj-art-a4433be9b935448c8e389151ffd60b5e2025-08-20T03:26:26ZengElsevierJACC: Advances2772-963X2025-08-014810189410.1016/j.jacadv.2025.101894Subclinical Myocardial Injury and Global Cognitive PerformanceShubham Tomar, MBBS, MPH0Karita C.F. Lidani, MD, MSc, PhD1Aline A.I. Moraes, MD, PhD2Shi Huang, PhD3Christian Oakley, BS4Khurram Nasir, MD, MPH5Michael J. Blaha, MD, MPH6Susan R. Heckbert, MD, PhD7Timothy M. Hughes, PhD8Christopher R. deFilippi, MD9Yader Sandoval, MD10Allan S. Jaffe, MD11Andrew P. DeFilippis, MD, MSc12Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USADivision of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USADepartment of Medicine, Pontifical Catholic University of Paraná, Curitiba, BrazilDivision of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USADivision of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USADivision of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas, USACiccarone Center for the Prevention of Heart Disease, Johns Hopkins Medical Institutions, Baltimore, Maryland, USADepartment of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USASection of Gerontology & Geriatric Medicine, Department of Medicine, Wake Forest University, School of Medicine, Salem, North Carolina, USAInova Heart and Vascular Institute, Falls Church, Virginia, USAMinneapolis Heart Institute, Minneapolis, Minnesota, USADepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USADivision of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Address for correspondence: Dr Andrew P. DeFilippis, Vanderbilt University Medical Center, 1215 21st Avenue South, MCE 5th Floor, North Tower, Nashville, Tennessee 37232, USA.Background: Cognitive impairment is common in cardiovascular disease (CVD) patients. Objectives: The purpose of this study was to evaluate the relationship of myocardial injury, measured by high-sensitivity cardiac troponin T (hs-cTnT), with global cognitive performance and its decline over time. Methods: Hs-cTnT assessed at baseline (2000-2002) and exam 5 (2010-2012) in 4,445 participants. Cognitive function evaluated using the Cognitive Abilities Screening Instrument (CASI) at exams 5 and 6 (2016-2018). Subclinical myocardial injury defined as hs-cTnT above limits of detection but below 19 ng/L, while clinical myocardial injury >19 ng/L. Cognitive decline was a >5 point decrease in CASI scores from exam 5 to 6. Regression analysis assessed the association of hs-cTnT levels with CASI scores and their decline. Results: Mean age at baseline was 60 years with 53% females. At baseline and exam 5, 63% and 87% had subclinical myocardial injury, respectively. Higher Log10(hs-cTnT) at baseline (β = −1.45 [95% CI: −2.5 to −0.41]), exam 5 (β = −1.63 [95% CI: −2.7 to −0.59]), and greater baseline to exam 5 increase (β = −1.42 [95% CI: −2.8 to −0.06]) were associated with lower CASI scores at exam 5, after adjusting for demographics, education, language, and apolipoprotein E status. These estimate lost significance after CVD risk factor adjustment. Higher Log10(hs-cTnT) at baseline (OR: 2.02 [95% CI: 1.29-3.12]), exam 5 (OR: 2.52 [95% CI: 1.56-4.05]), or greater baseline to exam 5 increase (OR: 2.22 [95% CI: 1.18-4.15]) were associated with higher odds of cognitive decline in fully adjusted models. Conclusions: In community-based cohort, higher or increasing hs-cTnT was associated with greater odds of future cognitive decline over 6 years of follow-up.http://www.sciencedirect.com/science/article/pii/S2772963X2500314XcognitionCognitive Ability Screening Instrumentcognitive performancehigh-sensitivity cardiac troponinmyocardial injury |
| spellingShingle | Shubham Tomar, MBBS, MPH Karita C.F. Lidani, MD, MSc, PhD Aline A.I. Moraes, MD, PhD Shi Huang, PhD Christian Oakley, BS Khurram Nasir, MD, MPH Michael J. Blaha, MD, MPH Susan R. Heckbert, MD, PhD Timothy M. Hughes, PhD Christopher R. deFilippi, MD Yader Sandoval, MD Allan S. Jaffe, MD Andrew P. DeFilippis, MD, MSc Subclinical Myocardial Injury and Global Cognitive Performance JACC: Advances cognition Cognitive Ability Screening Instrument cognitive performance high-sensitivity cardiac troponin myocardial injury |
| title | Subclinical Myocardial Injury and Global Cognitive Performance |
| title_full | Subclinical Myocardial Injury and Global Cognitive Performance |
| title_fullStr | Subclinical Myocardial Injury and Global Cognitive Performance |
| title_full_unstemmed | Subclinical Myocardial Injury and Global Cognitive Performance |
| title_short | Subclinical Myocardial Injury and Global Cognitive Performance |
| title_sort | subclinical myocardial injury and global cognitive performance |
| topic | cognition Cognitive Ability Screening Instrument cognitive performance high-sensitivity cardiac troponin myocardial injury |
| url | http://www.sciencedirect.com/science/article/pii/S2772963X2500314X |
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