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Updated: Sep 18, 2025

Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions

Published on: April 23, 2021

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Subclinical Myocardial Injury and Global Cognitive Performance: MESA (Multi-Ethnic Study of Atherosclerosis)

Shubham Tomar1, Karita C F Lidani1, Aline A I Moraes2

  • 1Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

JACC. Advances
|June 24, 2025
PubMed

Insights

Elevated or rising high-sensitivity cardiac troponin T (hs-cTnT) levels are linked to increased odds of future cognitive decline in individuals with cardiovascular disease (CVD). This highlights a potential biomarker for monitoring brain health in at-risk populations.

Area of Science:

  • Cardiology
  • Neurology
  • Biomarker Research

Background:

  • Cognitive impairment is a frequent complication among patients diagnosed with cardiovascular disease (CVD).
  • Understanding the underlying mechanisms linking CVD to cognitive decline is crucial for patient management.
  • Myocardial injury biomarkers may offer insights into this relationship.

Purpose of the Study:

  • To investigate the association between myocardial injury, quantified by high-sensitivity cardiac troponin T (hs-cTnT), and cognitive function.
  • To determine if hs-cTnT levels predict global cognitive performance and its longitudinal decline over time.

Main Methods:

  • Longitudinal study of 4,445 participants, assessing hs-cTnT at baseline and exam 5.
  • Cognitive function evaluated using the Cognitive Abilities Screening Instrument (CASI) at exams 5 and 6.
  • Subclinical myocardial injury defined as hs-cTnT between limits of detection and 19 ng/L; clinical injury >19 ng/L. Cognitive decline defined as a >5 point CASI decrease.

Main Results:

  • Higher baseline and exam 5 hs-cTnT levels, and increases between these time points, were associated with lower cognitive scores.
  • These associations lost significance after adjusting for CVD risk factors.
  • However, higher or increasing hs-cTnT levels were significantly associated with a greater odds of cognitive decline over 6 years in fully adjusted models.

Conclusions:

  • In a community-based cohort, elevated or increasing hs-cTnT levels are linked to an increased risk of future cognitive decline.
  • hs-cTnT may serve as a valuable biomarker for predicting cognitive trajectory in individuals with or at risk for CVD.
Abstract

Keywords:
Cognitive Ability Screening Instrumentcognitioncognitive performancehigh-sensitivity cardiac troponinmyocardial injury

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