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Cognitive performance in patients with ischemic stroke and additional myocardial injury - results from the

Regina von Rennenberg1,2,3, Simon Litmeier4,5, Kristina Szabo6

  • 1Department of Neurology with Experimental Neurology, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany. regina-irene.freiin-von-rennenberg@charite.de.

Neurological Research and Practice
|November 4, 2025
PubMed

Insights

Myocardial injury severity, not acute injury, is linked to cognitive impairment in stroke patients. Higher cardiac troponin levels correlate with poorer cognitive function post-stroke.

Area of Science:

  • Cardiology and Neurology
  • Biomarkers in Stroke
  • Cognitive Impairment Research

Background:

  • Cognitive impairment and dementia are more prevalent in individuals with prior myocardial injury (elevated high-sensitive cardiac troponin, hs-cTn).
  • Limited data exists on the relationship between myocardial injury and cognitive outcomes specifically in stroke patients.
  • This study investigates the association between myocardial injury severity and cognitive performance following acute ischemic stroke.

Purpose of the Study:

  • To analyze the association between the degree of myocardial injury (hs-cTn elevation) and cognitive performance after acute ischemic stroke.
  • To determine if the presence of acute myocardial injury (dynamic hs-cTn changes) impacts cognitive outcomes.
  • To evaluate cognitive performance over time in stroke patients with varying levels of myocardial injury.

Main Methods:

  • A prespecified analysis of the prospective, multicenter observational PRAISE study involving 254 acute ischemic stroke or TIA patients with myocardial injury.
  • Cognitive assessments were conducted at baseline, hospital discharge (Montreal Cognitive Assessment, MoCA), and at 3 and 12 months (Telephone Interview for Cognitive Status, TICS).
  • Linear regression and generalized linear models were used to analyze associations between hs-cTn levels, acute myocardial injury, and cognitive scores over time.

Main Results:

  • Greater severity of myocardial injury was significantly associated with lower MoCA scores (adjusted beta -2.6) and a higher proportion of cognitive impairment (adjusted OR 2.9).
  • The presence of acute myocardial injury showed an association with better cognitive performance (adjusted beta 1.8).
  • No significant association was found between hs-cTn levels and cognitive decline over a twelve-month period.

Conclusions:

  • In patients experiencing ischemic stroke, the overall severity of myocardial injury is linked to cognitive impairment.
  • The presence of acute myocardial injury at the time of stroke does not appear to be associated with cognitive impairment.
  • Further research is needed to understand the mechanisms linking myocardial injury severity and cognitive outcomes in stroke survivors.
Abstract

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