The role of biomarkers of endothelial dysfunction in predicting the progression of mild cognitive impairment in patients with cardiovascular risk factors

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OBJECTIVE

To develop a predictive model to assess the risk of progression of mild cognitive impairment (MCI) within 12 weeks in patients with cardiovascular risk factors using biomarkers of endothelial dysfunction.

MATERIAL AND METHODS

The study included 287 patients (mean age 64.3 years, 123 (42.9%) men) who met the inclusion criteria. All participants, at baseline and after 12 weeks, underwent neuropsychological testing using the Montreal Cognitive Assessment (MoCA) and laboratory blood tests to determine the levels of markers of endothelial inflammation (C-reactive protein (CRP), monocyte chemoattractant protein) and endothelial dysfunction (endothelin-1, endothelial NO-synthase (eNOS), endothelial growth factor, desquamated endothelial cells, S100B, von Willebrand factor, fibrinogen). During the study, patients took stable basic therapy. The demographic and anamnestic data, the results of neuropsychological testing and laboratory tests were used to construct a model of predictors that determine the trajectory of MCI using binary logistic regression, followed by calculation of its threshold indicator as a value for predicting the progression of MCI.

RESULTS

Age (p=0.00008), previous ischemic stroke (IS) (p=0.00001), MoCA index of executive functions ≤13 points (p=0.001) and MoCA index speech ≤6 points (p=0.024), eNOS ≥450 pg/ml (p=0.002), CRP ≥1 mg/ml (p=0.00006) and fibrinogen ≥4 g/l (p=0.0042) are independent predictors for the MCI progression. ROC-analysis showed a high predictive ability of the model with a threshold value of 0.4 (sensitivity 82.1%, specificity 72.3%).

CONCLUSION

Age, a history of IS, disorders of executive functions and speech, together with elevated values of CRP, fibrinogen, eNOS are important conditions for predicting the progression of MCI in patients with cardiovascular risk factors. These predictors and the risk of MCI progression calculated on their basis can be used as a tool for early diagnosis of dementia and in developing measures to prevent the progression of non-dementia cognitive impairment.

Keywords:

endothelial dysfunction

mild cognitive impairment

cardiovascular risk factors

prognosis

Authors:

Vorob’eva O.V.

Sechenov First Moscow State Medical University (Sechenov University)

ORCID: 0000-0001-5070-926X

Fateeva V.V.

Pirogov Russian National Research Medical University;
Federal Scientific and Clinical Center for Resuscitation and Rehabilitology

ORCID: 0000-0001-9935-3962

Received:

03.06.2024

Accepted:

06.06.2024

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