N-Terminal Pro-B Type Natriuretic Peptide is Associated with Mild Cognitive Impairment in the General Population

Article type: Research Article

Authors: Kara, Kaffer^{a; *} | Mahabadi, Amir Abbas^b | Weimar, Christian^c | Winkler, Angela^c | Neumann, Till^b | Kälsch, Hagen^b | Dragano, Nico^d | Moebus, Susanne^e | Erbel, Raimund^e | Jöckel, Karl-Heinz^{e; 1} | Jokisch, Martha^{c; 1}

Affiliations: [a] Cardiovascular Center, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany | [b] West-German Heart and Vascular Center, Department of Cardiology, University of Duisburg-Essen, Essen, Germany | [c] Department of Neurology, University Hospital of Essen, University of Duisburg-Essen, Germany | [d] Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany | [e] Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany

Correspondence: [*] Correspondence to: Kaffer Kara, MD, Cardiovascular Center, St. Josef Hospital, Ruhr-University Bochum, Gudrunstr. 56, 44791 Bochum, Germany. Tel.: +49 234 5092301; Fax: +49 2345092303; E-mail: k.kara@klinikum-bochum.de.

Note: [1] These authors contributed equally to this work.

Abstract: Background: N-terminal pro-B type natriuretic peptide (NT-proBNP) is a marker of cardiac stress and is linked with silent cardiac diseases. While associations of cognitive impairment with manifest cardiovascular diseases are established, data on whether subclinical elevation of NT-proBNP levels below clinically established threshold of heart failure is related with cognitive functioning, especially mild cognitive impairment (MCI), is rare. Objective: Aim of the present study was to investigate the cross-sectional association of NT-proBNP levels and MCI in a population-based study sample without heart failure. Methods: We used data from the second examination of the population based Heinz-Nixdorf-Recall-Study. Subjects with overt coronary heart disease and subjects with NT-proBNP levels indicating potential heart failure (NT-proBNP≥300 pg/ml) were excluded from this analysis. Participants performed a validated brief cognitive assessment and were classified either as MCI [subtypes: amnestic-MCI (aMCI), non-amnestic-MCI (naMCI)], or cognitively-normal. Results: We included 419 participants with MCI (63.1±7.4 y; 47% men; aMCI n = 209; naMCI n = 210) and 1,206 cognitively normal participants (62.42±7.1 y; 48% men). NT-proBNP-levels≥125 pg/ml compared to <125 pg/ml were associated with MCI in fully adjusted models (OR 1.65 (1.23;2.23) in the total sample, 1.73 (1.09;2.74) in men and 1.63(1.10;2.41) in women). For aMCI, the fully adjusted OR was 1.53 (1.04;2.25) and for naMCI, the fully adjusted OR was 1.34 (1.09; 166) in the total sample. Conclusion: Within normal ranges and without manifest heart failure, higher NT-proBNPlevels are associated with MCI and both MCI subtypes independent of traditional cardiovascular risk factors and sociodemographic parameters.

Keywords: Alzheimer’s disease, BNP, mild cognitive impairment, natriuretic peptides, NT-proBNP

DOI: 10.3233/JAD-160635

Journal: Journal of Alzheimer's Disease, vol. 55, no. 1, pp. 359-369, 2017