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

McLennan, Skye N., Pearson, Sue A., Cameron, Janette and Stewart, Simon (2006) Prognostic importance of cognitive impairment in chronic heart failure patients: Does specialist management make a difference?. European Journal Of Heart Failure, 8 5: 494-501. doi:10.1016/j.ejheart.2005.11.013


Author McLennan, Skye N.
Pearson, Sue A.
Cameron, Janette
Stewart, Simon
Title Prognostic importance of cognitive impairment in chronic heart failure patients: Does specialist management make a difference?
Journal name European Journal Of Heart Failure   Check publisher's open access policy
ISSN 1388-9842
1388-9842
Publication date 2006-08-01
Sub-type Article (original research)
DOI 10.1016/j.ejheart.2005.11.013
Open Access Status Not Open Access
Volume 8
Issue 5
Start page 494
End page 501
Total pages 8
Place of publication Oxford, England
Publisher Oxford University Pres
Language eng
Subject CX
1102 Cardiovascular Medicine and Haematology
Formatted 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<0.001) and/or experience an unplanned hospitalization (100% versus 94%. RR 1.44, 95% CI 1.06 to 1.95: P=0.019). Cognitively impaired patients had a similar (non-significant) adjusted risk of death-or-readmission in both the CHF-MP (RR 1.40, 95% CI 0.63 to 3.11: P=0.403) and in usual care (RR 1.38, 95% CI 0.75 to 2.53: P=0.305). In the usual care cohort, cognitive impairment was associated with a greater (non-significant), adjusted risk of death (RR 1.61, 95% CI 1.10 to 4.92: P=0.122). In the CHF-MP, adjusted risk of death was significantly higher for cognitively impaired patients (RR 2.33, 95% CI 1.10 to 4.92: P=0.027).

Conclusion: 
These data suggest that “mild” cognitive impairment is of prognostic importance in CHF: even when a CHF-MP has been applied.
Keyword chronic heart failure
cognitive impairment
prognosis
management
Q-Index Code CX

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 46 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 57 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Wed, 15 Aug 2007, 19:07:27 EST