Clinical Correlates and Prognostic Impact of Cognitive Dysfunction in Patients With Heart Failure and Preserved Ejection Fraction: Insights From PARAGON-HF

Cognitive impairment is common in patients with heart failure and preserved ejection fraction but its clinical correlates and prognostic associations are poorly understood. We analyzed cognitive function, using the Mini-Mental State Examination (MMSE), in patients with heart failure and preserved ej...

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Veröffentlicht in:Circulation (New York, N.Y.) N.Y.), 2024-12, Vol.150 (24), p.1913-1927
Hauptverfasser: Shen, Li, Dewan, Pooja, Ferreira, João Pedro, Cunningham, Jonathan W, Jhund, Pardeep S, Anand, Inder S, Chandra, Alvin, Chiang, Lu-May, Claggett, Brian, Desai, Akshay S, Gong, Jianjian, Lam, Carolyn S P, Lefkowitz, Martin P, Maggioni, Aldo P, Martinez, Felipe, Packer, Milton, Redfield, Margaret M, Rouleau, Jean L, van Veldhuisen, Dirk J, Zannad, Faiez, Zile, Michael R, Solomon, Scott D, McMurray, John J V
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Sprache:eng
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Zusammenfassung:Cognitive impairment is common in patients with heart failure and preserved ejection fraction but its clinical correlates and prognostic associations are poorly understood. We analyzed cognitive function, using the Mini-Mental State Examination (MMSE), in patients with heart failure and preserved ejection fraction enrolled in a prespecified substudy of the PARAGON-HF trial (Prospective Comparison of Angiotensin Receptor Neprilysin Inhibitor With Angiotensin Receptor Blocker Global Outcomes in Heart Failure With Preserved Ejection Fraction). Logistic regression analyses were performed to determine the variables associated with lower MMSE scores at baseline and postbaseline decline in MMSE scores at 48 weeks. Cox proportional hazards regression and semiparametric proportional rates models were used to examine the risk of clinical outcomes related to baseline MMSE scores, and decline in MMSE scores during follow-up, adjusted for prognostic variables including NT-proBNP (N-terminal pro-B-type natriuretic peptide). At baseline, cognitive function was normal (MMSE score 28-30) in 1809 of 2895 patients (62.5%), borderline (score 24-27) in 794 (27.4%), and impaired (score
ISSN:0009-7322
1524-4539
1524-4539
DOI:10.1161/CIRCULATIONAHA.124.070553