Abstract 11562: Amino-Terminal Pro-B-Type Natriuretic Peptide (NT-Pro-BNP) and Risk of Cognitive Decline: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Cohort
Background: Higher NT-pro-BNP is a biomarker of cardiac dysfunction, and was also recently reported as a stroke risk marker. Given the associations of stroke risk factors with cognitive decline we studied the association of NT-pro-BNP with cognitive decline.
Methods: REGARDS enrolled 30,239 US adults in 2003-07 (41% black, 59% white, 55% living in the southeastern stroke belt). Using a nested case control study design, we studied the association of baseline NT-pro-BNP with cognitive decline among those cognitively intact at baseline and without prevalent stroke. Cognitive decline was defined as impairment at the most recent assessment on at least 2 of 3 tests: word list learning, word list recall and semantic fluency, over a mean follow-up of 3.4 years. Baseline NT-pro-BNP was measured in 495 subjects with cognitive decline and 587 controls. Logistic regression was used to calculate odds ratios (OR) of cognitive decline by quartiles of NT-pro-BNP, adjusting for confounders.
Results: Baseline NT-pro-BNP was higher with older age, in whites, women, and those with diabetes, impaired kidney function, atrial fibrillation, prebaseline heart disease and left ventricular hypertrophy. Adjusting for age, race, region of residence, education and income there was an increased OR of cognitive decline with increasing quartiles of NT-pro-BNP (Model 1 in table); subjects in the 4th versus 1st quartile had a 1.7-fold increased odds. Adjustment for other covariates had no substantial impact on the OR (table). Discussion: Higher NT-pro-BNP was associated with cognitive decline in this prospective cohort study. More work is needed to clarify the pathophysiologic connections of cardiac dysfunction and cognitive decline.
- © 2013 by American Heart Association, Inc.