Cognitive performance in patients with ischemic stroke and additional myocardial injury – results from the multicenter prospective observational PRAISE study
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
BACKGROUND: In the general population, cognitive impairment and dementia are more common in individuals with prior myocardial injury, defined as elevated levels of high-sensitive cardiac troponin (hs-cTn). In stroke patients, data on the link between myocardial injury and cognitive outcome are scarce. We aimed to analyze the association between the severity of myocardial injury (degree of hs-cTn elevation), presence of acute myocardial injury (dynamic change in elevated hs-cTn values > 20% in serial measurements) and cognitive performance over time after acute ischemic stroke. METHODS: This is a prespecified analysis of the prospective multicenter observational PRediction of Acute coronary syndrome in acute Ischemic StrokE (PRAISE) study. PRAISE included 254 patients with an acute ischemic stroke or transient ischemic attack (TIA) and myocardial injury in 26 centers in Germany. Patients underwent cognitive assessment at baseline and before hospital discharge using the Montreal Cognitive Assessment (MoCA) and at three and twelve months after the index event using the Telephone Interview for Cognitive Status (TICS). We used linear regression to analyze the associations between cognitive performance and (1) severity of myocardial injury and (2) presence of acute myocardial injury. The association between hs-cTn and TICS scores over time was examined using inverse probability weighted generalized linear models. RESULTS: Severity of myocardial Injury was associated with lower MoCA scores (adjusted beta - 2.6, 95% CI -4.0 - -1.2, p < 0.001) and higher proportion of cognitive impairment (i.e. MoCA score < 26 points) (adjusted OR 2.9, 95%CI 1.3-6.7, p = 0.012). Acute myocardial injury was associated with better cognitive performance (adjusted beta 1.8, 95% CI 0.4-3.1, p = 0.011). We found no association between hs-cTn and cognitive decline over twelve months. CONCLUSIONS: In patients with ischemic stroke, the severity of myocardial injury in general but not the presence of acute myocardial injury at time of stroke is associated with cognitive impairment. TRIAL REGISTRATION: Clinicaltrials.gov NCT03609385 https://clinicaltrials.gov/study/NCT03609385?term=NCT03609385&rank=1 Date of registration 6th July 2018.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.016 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it