Relationship between Subclinical Myocardial Injury and Global Cognitive Performance: The Multi-Ethnic Study of Atherosclerosis (MESA)
Abstract Body (Do not enter title and authors here): Background: With demographic trends transitioning towards older adults, dementia and cognitive impairment are predicted to increase dramatically. We aim to elucidate the relationship between subclinical myocardial injury, as indicated by asymptomatic increased levels of high-sensitivity cardiac Troponin (hs-cTnT), and cognitive performance.
Methods: We studied MESA participants from Exam 1 (2000-02) to Exam 6 (2016-18), categorizing them based on baseline hs-cTnT at Exam 1. Cognitive decline was defined as a decrease of ≥5 units in CASI between Exam 5 & 6. We used Pearson correlation and linear regression to analyze the association of hs-cTnT levels with CASI scores, and logistic regression to examine the association with cognitive decline. We also explored the relationship between different hs-cTnT categories and cognitive measures. Models were adjusted for demographics, lifestyle, APOE status, comorbidities, and medication use (Figure).
Results: 4445 participants had both baseline hs-cTnT and valid Exam 5 CASI scores while only 1776 participants had valid Exam 6 CASI scores. Cohort was predominantly female (53%), mean age of 60 years, and 27% had at least one APOE e4 allele. Median hs-cTnT was 6.32 ng/L, and median CASI scores were 89 at Exam 5 and 91.5 at Exam 6. We found a negative correlation between the log-hs-cTnT at Exam 1 and Exam 5 with CASI scores at Exam 5. An increase of one unit in log-hs-cTnT level was associated with a decrease of 0.67 (CI -1.17, -0.17) in CASI and corresponded to higher odds (OR: 1.44; CI 1.05-1.95) of cognitive decline, after adjusting for covariates. When comparing various categories of hs-cTnT with category 1, we observe that the odd of cognitive decline increases as the category increases. However, this trend does not hold for category 5 with significantly lower sample size (Figure).
Conclusion: Our findings indicate an inverse relationship between hs-cTnT and cognitive function years later, which is significantly attenuated by known risk factors for cognitive decline. Further research is needed to determine hs-cTnT as a predictor of future global cognitive functions.
Tomar, Shubham
( Vanderbilt University Medical Center
, Nashville
, Tennessee
, United States
)
Sandoval, Yader
( Minneapolis Heart Institute
, Minneapolis
, Minnesota
, United States
)
Jaffe, Allan
( Mayo Clinic
, Rochester
, Minnesota
, United States
)
Defilippis, Andrew
( Vanderbilt University Medical Center
, Nashville
, Tennessee
, United States
)
Lidani, Karita
( Vanderbilt University Medical Center
, Nashville
, Tennessee
, United States
)
Moraes, Aline
( Pontifical Catholic University of Paraná
, Curitiba
, Brazil
)
Huang, Shi
( Vanderbilt University Medical Center
, Nashville
, Tennessee
, United States
)
Nasir, Khurram
( Houston Methodist DeBakey Heart & Vascular Center
, Houston
, Texas
, United States
)
Blaha, Michael
( Johns Hopkins Medical Institutions
, Baltimore
, Maryland
, United States
)
Heckbert, Susan
( University of Washington, School of Public Health
, Seattle
, Washington
, United States
)
Hughes, Timothy
( Wake Forest University, School of Medicine
, Salem
, North Carolina
, United States
)
Defilippi, Christopher
( Inova Heart and Vascular Institute
, Falls Church
, Virginia
, United States
)
Author Disclosures:
Shubham Tomar:DO NOT have relevant financial relationships
| Yader Sandoval:DO have relevant financial relationships
;
Advisor:Philips:Active (exists now)
; Royalties/Patent Beneficiary:Patent #20210401347:Active (exists now)
; Advisor:Zoll:Past (completed)
; Advisor:Abbott Diagnostics:Past (completed)
; Advisor:Roche Diagnostics:Active (exists now)
; Advisor:GE:Active (exists now)
| Allan Jaffe:DO have relevant financial relationships
;
Consultant:Abbott:Active (exists now)
; Royalties/Patent Beneficiary:RCE Technologies:Active (exists now)
; Consultant:Spinchip:Active (exists now)
; Consultant:Moderna:Active (exists now)
; Consultant:Sphingotec:Active (exists now)
; Consultant:ET Healthcare:Active (exists now)
; Consultant:Radiometer:Active (exists now)
; Consultant:Roche:Active (exists now)
; Consultant:Siemens:Active (exists now)
| Andrew DeFilippis:DO have relevant financial relationships
;
Researcher:National Institutes of Health:Active (exists now)
; Consultant:Velakor:Past (completed)
; Researcher:Ionis:Past (completed)
| Karita Lidani:DO NOT have relevant financial relationships
| Aline Moraes:DO NOT have relevant financial relationships
| Shi Huang:DO NOT have relevant financial relationships
| Khurram Nasir:DO NOT have relevant financial relationships
| Michael Blaha:DO have relevant financial relationships
;
Research Funding (PI or named investigator):Bayer:Active (exists now)
; Advisor:New Amsterdam:Expected (by end of conference)
; Advisor:Vectura:Past (completed)
; Advisor:Agepha:Active (exists now)
; Advisor:Astra Zeneca:Past (completed)
; Advisor:Eli Lilly:Active (exists now)
; Advisor:Boehringer Ingelheim:Active (exists now)
; Advisor:Roche:Past (completed)
; Advisor:Merck:Past (completed)
; Advisor:Bayer:Active (exists now)
; Advisor:Novartis:Active (exists now)
; Advisor:Novo Nordisk:Active (exists now)
; Researcher:Amgen:Past (completed)
| Susan Heckbert:DO NOT have relevant financial relationships
| Timothy Hughes:No Answer
| Christopher deFilippi:DO have relevant financial relationships
;
Consultant:Roche:Active (exists now)
; Royalties/Patent Beneficiary:UpToDate:Active (exists now)
; Consultant:Tosoh:Active (exists now)
; Consultant:FujiRebio:Past (completed)
; Consultant:Quidel:Ortho:Active (exists now)
; Consultant:Siemens:Active (exists now)
; Consultant:Abbott:Active (exists now)