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...
Autores principales: | , , , , , , |
---|---|
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 |