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
{"title":"亚临床心肌损伤与整体认知表现","authors":"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","doi":"10.1016/j.jacadv.2025.101894","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Cognitive impairment is common in cardiovascular disease (CVD) patients.</div></div><div><h3>Objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>Mean age at baseline was 60 years with 53% females. At baseline and exam 5, 63% and 87% had subclinical myocardial injury, respectively. Higher Log<sub>10</sub>(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 Log<sub>10</sub>(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.</div></div><div><h3>Conclusions</h3><div>In community-based cohort, higher or increasing hs-cTnT was associated with greater odds of future cognitive decline over 6 years of follow-up.</div></div>","PeriodicalId":73527,"journal":{"name":"JACC advances","volume":"4 8","pages":"Article 101894"},"PeriodicalIF":0.0000,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Subclinical Myocardial Injury and Global Cognitive Performance\",\"authors\":\"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\",\"doi\":\"10.1016/j.jacadv.2025.101894\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Cognitive impairment is common in cardiovascular disease (CVD) patients.</div></div><div><h3>Objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>Mean age at baseline was 60 years with 53% females. At baseline and exam 5, 63% and 87% had subclinical myocardial injury, respectively. Higher Log<sub>10</sub>(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 Log<sub>10</sub>(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.</div></div><div><h3>Conclusions</h3><div>In community-based cohort, higher or increasing hs-cTnT was associated with greater odds of future cognitive decline over 6 years of follow-up.</div></div>\",\"PeriodicalId\":73527,\"journal\":{\"name\":\"JACC advances\",\"volume\":\"4 8\",\"pages\":\"Article 101894\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-06-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JACC advances\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2772963X2500314X\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JACC advances","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2772963X2500314X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
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.
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.
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