Prognostic importance of cognitive impairment in chronic heart failure patients: Does specialist management make a difference?

Abstract Background: Cognitive impairment is common among chronic heart failure (CHF) patients. Aims: To determine the prognostic significance of cognitive impairment in patients participating in a randomized study of a CHF management program (CHF-MP). Methods CHF patients were randomized to a CHF-MP (n=100) or usual care (n=100). Baseline cognition was assessed using the Mini Mental Status Examination (MMSE). Five-year all-cause mortality, and combined death-or-readmission, were compared on the basis of the presence (MMSE 19-26) or absence (MMSE >26) of cognitive impairment. Results: 27 patients (13.5%) had cognitive impairment and, on an adjusted basis, were more likely to die (96.3% versus 68.2%. RR 2.19, 95% CI 1.41 to 3.39: P