Cognitive function in ambulatory patients with systolic heart failure: Insights from the warfarin versus aspirin in reduced cardiac ejection fraction (warcef) trial

Susan Graham, Siqin Ye, Min Qian, Alexra R. Sanford, Marco R Di Tullio, Ralph L Sacco, Douglas L. Mann, Bruce Levin, Patrick M. Pullicino, Ronald S. Freudenberger, John R. Teerlink, J. P. Mohr, Arthur J. Labovitz, Gregory Y H Lip, Conrado J. Estol, Dirk J. Lok, Piotr Ponikowski, Stefan D. Anker, John L P Thompson, Shunichi Homma

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

We sought to determine whether cognitive function in stable outpatients with heart failure (HF) is affected by HF severity. A retrospective, cross-sectional analysis was performed using data from 2, 043 outpatients with systolic HF and without prior stroke enrolled in the Warfarin versus Aspirin in Reduced Cardiac Ejection Fraction (WARCEF) Trial. Multivariable regression analysis was used to assess the relationship between cognitive function measured using the Mini-Mental Status Exam (MMSE) and markers of HF severity (left ventricular ejection fraction [LVEF], New York Heart Association [NYHA] functional class, and 6-minute walk distance). The mean (SD) for the MMSE was 28.6 (2.0), with 64 (3.1%) of the 2,043 patients meeting the cut-off of MMSE ,<24 that indicates need for further evaluation of cognitive impairment. After adjustment for demographic and clinical covariates, 6-minute walk distance (β-coefficient 0.002, p<0.0001), but not LVEF or NYHA functional class, was independently associated with the MMSE as a continuous measure. Age, education, smoking status, body mass index, and hemoglobin level were also independently associated with the MMSE. In conclusion, six-minute walk distance, but not LVEF or NYHA functional class, was an important predictor of cognitive function in ambulatory patients with systolic heart failure.

Original languageEnglish
Article numbere113447
JournalPLoS One
Volume9
Issue number11
DOIs
StatePublished - Nov 26 2014

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Systolic Heart Failure
warfarin
aspirin
heart failure
Warfarin
cognition
Stroke Volume
Cognition
Aspirin
Heart Failure
Outpatients
heart
Hemoglobins
Body Mass Index
Cross-Sectional Studies
Smoking
Stroke
Regression Analysis
Demography
Education

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Cognitive function in ambulatory patients with systolic heart failure : Insights from the warfarin versus aspirin in reduced cardiac ejection fraction (warcef) trial. / Graham, Susan; Ye, Siqin; Qian, Min; Sanford, Alexra R.; Tullio, Marco R Di; Sacco, Ralph L; Mann, Douglas L.; Levin, Bruce; Pullicino, Patrick M.; Freudenberger, Ronald S.; Teerlink, John R.; Mohr, J. P.; Labovitz, Arthur J.; Lip, Gregory Y H; Estol, Conrado J.; Lok, Dirk J.; Ponikowski, Piotr; Anker, Stefan D.; Thompson, John L P; Homma, Shunichi.

In: PLoS One, Vol. 9, No. 11, e113447, 26.11.2014.

Research output: Contribution to journalArticle

Graham, S, Ye, S, Qian, M, Sanford, AR, Tullio, MRD, Sacco, RL, Mann, DL, Levin, B, Pullicino, PM, Freudenberger, RS, Teerlink, JR, Mohr, JP, Labovitz, AJ, Lip, GYH, Estol, CJ, Lok, DJ, Ponikowski, P, Anker, SD, Thompson, JLP & Homma, S 2014, 'Cognitive function in ambulatory patients with systolic heart failure: Insights from the warfarin versus aspirin in reduced cardiac ejection fraction (warcef) trial', PLoS One, vol. 9, no. 11, e113447. https://doi.org/10.1371/journal.pone.0113447
Graham, Susan ; Ye, Siqin ; Qian, Min ; Sanford, Alexra R. ; Tullio, Marco R Di ; Sacco, Ralph L ; Mann, Douglas L. ; Levin, Bruce ; Pullicino, Patrick M. ; Freudenberger, Ronald S. ; Teerlink, John R. ; Mohr, J. P. ; Labovitz, Arthur J. ; Lip, Gregory Y H ; Estol, Conrado J. ; Lok, Dirk J. ; Ponikowski, Piotr ; Anker, Stefan D. ; Thompson, John L P ; Homma, Shunichi. / Cognitive function in ambulatory patients with systolic heart failure : Insights from the warfarin versus aspirin in reduced cardiac ejection fraction (warcef) trial. In: PLoS One. 2014 ; Vol. 9, No. 11.
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