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High-sensitivity cardiac troponin I and NT-proBNP as predictors of incident dementia and Alzheimer’s disease: the FINRISK Study

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Abstract

Cardiac troponin and N-terminal pro-brain natriuretic peptide (NT-proBNP) are known to associate with incident dementia. The purpose of our study was to examine whether high-sensitivity cardiac troponin I (hs-TnI) and NT-proBNP are associated with incident dementia and Alzheimer’s disease (AD) independently of each other. Our study was a part of the national population-based health examination survey, FINRISK 1997, with a total sample of 7114 subjects, including 407 incident dementia cases and 319 AD cases during the follow-up time of 18 years. Using multivariate Cox regression analyses, we calculated the hazard ratios (HR) for hs-TnI and NT-proBNP. Analyses were adjusted for the previously known dementia/AD risk factors, including the apoE genotype. NT-proBNP was independently associated with incident dementia (HR 1.32, 95% CI 1.17–1.49) and AD (HR 1.30, 95% CI 1.13–1.5). Hs-TnI was also associated with incident dementia (HR 1.12, 95% CI 1.02–1.23), but not independent of NT-proBNP (HR 1.10, 95% CI 0.99–1.21). Hs-TnI was not associated with incident AD. The results remained similar in cause-specific Cox regression models and among subjects over 40 years of age. NT-proBNP and hs-TnI improved the reclassification of dementia risk in 10 years follow-up, and hs-TNI also in 18 years of follow-up. Neither hs-TnI nor NT-proBNP was able to outperform each other in risk reclassification of dementia. Both cardiovascular biomarkers, NT-proBNP and hs-TnI, were associated with incident dementia independently of traditional dementia risk factors including the apoE genotype. NT-proBNP was also associated with AD. Both markers offered a better dementia risk reclassification compared with traditional risk factors.

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Acknowledgements

This work has been supported by the European Union Seventh Framework Programme (FP7/2007-2013) under grant agreement No. HEALTH-F2-2011-278913 (BiomarCaRE). Salomaa V. was supported by the Finnish Foundation for Cardiovascular Research. Tynkkynen J. was supported by North Karelian central hospital for conducting this paper as part of his doctoral thesis. None of the funders had any role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; or decision to submit the manuscript for publication. Tanja Zeller and Stefan Blankenberg are principal investigators of the DZHK (German Center for Cardiovascular Research.). Tynkkynen J. had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

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Authors and Affiliations

  1. Tampere University, Tampere, Finland

    Juho Tynkkynen & Jussi A. Hernesniemi

  2. National Institute for Health and Welfare, Helsinki, Finland

    Tiina Laatikainen, Aki S. Havulinna, Perttu Salo & Veikko Salomaa

  3. Institute of Public Health and Clinical Nutrition, university of Eastern Finland, Kuopio, Finland

    Tiina Laatikainen

  4. Hospital District of North Karelia, Joensuu, Finland

    Tiina Laatikainen

  5. Clinic for General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany

    Stefan Blankenberg & Tanja Zeller

  6. Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Partner Site Hamburg/Lübeck/Kiel, Hamburg, Germany

    Stefan Blankenberg & Tanja Zeller

  7. Sammonkatu 29 B 34, 33540, Tampere, Finland

    Juho Tynkkynen

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  1. Juho Tynkkynen
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  2. Jussi A. Hernesniemi
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Correspondence to Juho Tynkkynen.

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On behalf of all authors, the corresponding author states that there is no conflict of interest. All the participants gave a written informed consent and the survey was conducted in accordance with the Declaration of Helsinki. Ethics approval was received from the Ethics Committee of the National Public Health Institute.

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Tynkkynen, J., Hernesniemi, J.A., Laatikainen, T. et al. High-sensitivity cardiac troponin I and NT-proBNP as predictors of incident dementia and Alzheimer’s disease: the FINRISK Study. J Neurol 264, 503–511 (2017). https://doi.org/10.1007/s00415-016-8378-7

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