Cargando…

Subclinical Atherosclerosis, Cardiac and Kidney Function, Heart Failure, and Dementia in the Very Elderly

BACKGROUND: Heart failure (HF) and dementia are major causes of disability and death among older individuals. Risk factors and biomarkers of HF may be determinants of dementia in the elderly. We evaluated the relationship between biomarkers of cardiovascular disease and HF and risk of dementia and d...

Descripción completa

Detalles Bibliográficos
Autores principales: Kuller, Lewis H., Lopez, Oscar L., Gottdiener, John S., Kitzman, Dalane W., Becker, James T., Chang, Yuefang, Newman, Anne B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5586275/
https://www.ncbi.nlm.nih.gov/pubmed/28735291
http://dx.doi.org/10.1161/JAHA.116.005353
_version_ 1783261784134647808
author Kuller, Lewis H.
Lopez, Oscar L.
Gottdiener, John S.
Kitzman, Dalane W.
Becker, James T.
Chang, Yuefang
Newman, Anne B.
author_facet Kuller, Lewis H.
Lopez, Oscar L.
Gottdiener, John S.
Kitzman, Dalane W.
Becker, James T.
Chang, Yuefang
Newman, Anne B.
author_sort Kuller, Lewis H.
collection PubMed
description BACKGROUND: Heart failure (HF) and dementia are major causes of disability and death among older individuals. Risk factors and biomarkers of HF may be determinants of dementia in the elderly. We evaluated the relationship between biomarkers of cardiovascular disease and HF and risk of dementia and death. Three hypotheses were tested: (1) higher levels of high‐sensitivity cardiac troponin T, N‐terminal of prohormone brain natriuretic peptide, and cystatin C predict risk of death, cardiovascular disease, HF, and dementia; (2) higher levels of cardiovascular disease biomarkers are associated with increased risk of HF and then secondary increased risk of dementia; and (3) risk of dementia is lower among participants with a combination of lower coronary artery calcium, atherosclerosis, and lower high‐sensitivity cardiac troponin T (myocardial injury). METHODS AND RESULTS: The Cardiovascular Health Study Cognition Study was a continuation of the Cardiovascular Health Study limited to the Pittsburgh, PA, center from 1998–1999 to 2014. In 1992–1994, 924 participants underwent magnetic resonance imaging of the brain. There were 199 deaths and 116 developed dementia before 1998–1999. Of the 609 participants eligible for the Pittsburgh Cardiovascular Health Study Cognition Study, 87.5% (n=532) were included in the study. There were 120 incident HF cases and 72% had dementia. In 80 of 87, dementia preceded HF. A combination of low coronary artery calcium score and low high‐sensitivity cardiac troponin T was significantly associated with reduced risk of dementia and HF. CONCLUSIONS: Most participants with HF had dementia but with onset before HF. Lower high‐sensitivity cardiac troponin T and coronary artery calcium was associated with low risk of dementia based on a small number of events. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00005133.
format Online
Article
Text
id pubmed-5586275
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher John Wiley and Sons Inc.
record_format MEDLINE/PubMed
spelling pubmed-55862752017-09-11 Subclinical Atherosclerosis, Cardiac and Kidney Function, Heart Failure, and Dementia in the Very Elderly Kuller, Lewis H. Lopez, Oscar L. Gottdiener, John S. Kitzman, Dalane W. Becker, James T. Chang, Yuefang Newman, Anne B. J Am Heart Assoc Original Research BACKGROUND: Heart failure (HF) and dementia are major causes of disability and death among older individuals. Risk factors and biomarkers of HF may be determinants of dementia in the elderly. We evaluated the relationship between biomarkers of cardiovascular disease and HF and risk of dementia and death. Three hypotheses were tested: (1) higher levels of high‐sensitivity cardiac troponin T, N‐terminal of prohormone brain natriuretic peptide, and cystatin C predict risk of death, cardiovascular disease, HF, and dementia; (2) higher levels of cardiovascular disease biomarkers are associated with increased risk of HF and then secondary increased risk of dementia; and (3) risk of dementia is lower among participants with a combination of lower coronary artery calcium, atherosclerosis, and lower high‐sensitivity cardiac troponin T (myocardial injury). METHODS AND RESULTS: The Cardiovascular Health Study Cognition Study was a continuation of the Cardiovascular Health Study limited to the Pittsburgh, PA, center from 1998–1999 to 2014. In 1992–1994, 924 participants underwent magnetic resonance imaging of the brain. There were 199 deaths and 116 developed dementia before 1998–1999. Of the 609 participants eligible for the Pittsburgh Cardiovascular Health Study Cognition Study, 87.5% (n=532) were included in the study. There were 120 incident HF cases and 72% had dementia. In 80 of 87, dementia preceded HF. A combination of low coronary artery calcium score and low high‐sensitivity cardiac troponin T was significantly associated with reduced risk of dementia and HF. CONCLUSIONS: Most participants with HF had dementia but with onset before HF. Lower high‐sensitivity cardiac troponin T and coronary artery calcium was associated with low risk of dementia based on a small number of events. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00005133. John Wiley and Sons Inc. 2017-07-22 /pmc/articles/PMC5586275/ /pubmed/28735291 http://dx.doi.org/10.1161/JAHA.116.005353 Text en © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Research
Kuller, Lewis H.
Lopez, Oscar L.
Gottdiener, John S.
Kitzman, Dalane W.
Becker, James T.
Chang, Yuefang
Newman, Anne B.
Subclinical Atherosclerosis, Cardiac and Kidney Function, Heart Failure, and Dementia in the Very Elderly
title Subclinical Atherosclerosis, Cardiac and Kidney Function, Heart Failure, and Dementia in the Very Elderly
title_full Subclinical Atherosclerosis, Cardiac and Kidney Function, Heart Failure, and Dementia in the Very Elderly
title_fullStr Subclinical Atherosclerosis, Cardiac and Kidney Function, Heart Failure, and Dementia in the Very Elderly
title_full_unstemmed Subclinical Atherosclerosis, Cardiac and Kidney Function, Heart Failure, and Dementia in the Very Elderly
title_short Subclinical Atherosclerosis, Cardiac and Kidney Function, Heart Failure, and Dementia in the Very Elderly
title_sort subclinical atherosclerosis, cardiac and kidney function, heart failure, and dementia in the very elderly
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5586275/
https://www.ncbi.nlm.nih.gov/pubmed/28735291
http://dx.doi.org/10.1161/JAHA.116.005353
work_keys_str_mv AT kullerlewish subclinicalatherosclerosiscardiacandkidneyfunctionheartfailureanddementiaintheveryelderly
AT lopezoscarl subclinicalatherosclerosiscardiacandkidneyfunctionheartfailureanddementiaintheveryelderly
AT gottdienerjohns subclinicalatherosclerosiscardiacandkidneyfunctionheartfailureanddementiaintheveryelderly
AT kitzmandalanew subclinicalatherosclerosiscardiacandkidneyfunctionheartfailureanddementiaintheveryelderly
AT beckerjamest subclinicalatherosclerosiscardiacandkidneyfunctionheartfailureanddementiaintheveryelderly
AT changyuefang subclinicalatherosclerosiscardiacandkidneyfunctionheartfailureanddementiaintheveryelderly
AT newmananneb subclinicalatherosclerosiscardiacandkidneyfunctionheartfailureanddementiaintheveryelderly