Why the study?
Cognitive impairment is common in cardiovascular disease patients, but the relationship of myocardial injury measured by hs-cTnT with global cognitive performance and its decline over time needed evaluation.
In a diverse, community-based cohort, higher or increasing levels of high-sensitivity cardiac troponin T were independently associated with a greater risk of future cognitive decline.
hs-cTnT may flag cognitive risk in CVD patients; hypothesis-generating and requires prospective trials before any practice change.
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: (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.
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Lidani et al. (2025) studied this question.
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