Cardiac troponin T (cTnT) is a sensitive biomarker for myocardial injury and has been linked to incident dementia and severity of white matter lesions. We aimed to assess whether cTnT is associated with cognitive function and decline in first-ever ischemic stroke.
We used data from the Prospective Cohort with Incident Stroke Berlin (PROSCIS-B;NCT01363856). Patients with severe stroke (NIHSS>15), recent myocardial infarction, baseline use of dementia medication, and renal insufficiency were excluded from analysis. cTnT was measured using a high-sensitivity assay (hs-cTnT, Roche Elecsys®). Cognitive function was assessed by Mini-Mental-State-Examination (MMSE) at baseline and TICS-m (Telephone Interview for Cognitive Status-modified) during three-year follow-up. Patients were categorized into hs-cTnT quartiles. We performed unadjusted and adjusted (sex, age, cardiovascular risk factors) logistic regression to calculate odds ratios with 95%-CI of mild cognitive impairment (MCI;MMSE<27). A linear mixed model was used to assess the impact of hs-cTnT on cognitive decline.
We included 555 patients (mean age 67 years, 62% male). Median MMSE was 27 (IQR:24-29) for the highest hs-cTnT quartile (43.0% MCI) and 29 (IQR:28-30) for the lowest quartile (15.3% MCI). Adjusted odds ratio for MCI at baseline was 2.4 (95%-CI:1.2-4.7) for the highest quartile compared with the lowest. TICS-m scores were lower for the highest quartile compared with the lowest (β=-2.37, 95%-CI:-4.32 to -0.42) during three years of follow-up.
In non-demented patients with mild-to-moderate first-ever ischemic stroke, higher hs-cTnT was associated with a higher prevalence of MCI at baseline, and lower TICS-m during three years of follow-up.