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 HommaS. Ammon, B. Massie, C. Moy, P. Gilbert, L. Gutmann, J. Marler, V. Mejia, A. Gabriel, P. Czaja, Z. Gaciong, J. Gora, A. Kleinrok, G. Prokop-Lewicka, H. Haddad, R. Davies, L. Sitwell, J. Donaldson, T. To, R. Yufe, B. Donelly, T. Huynh, R. Cote, B. St Jacques, D. Borts, A. M. Sindilar, T. Winder, E. Janzen, C. Walker, G. Moe, N. Bayer, A. Konig, M. Arnold, D. Spence, J. Smith, R. Bessoudo, P. Bailey, A. McNulty, S. Nawaz, C. Dewar, M. Rajda, M. MacFarlane, J. Minuk, C. Schanz, A. Penn, L. Atkins, A. Ducharme, H. Brown, S. Zieroth, A. Muñoz, J. B. ten Holter, C. Huls, P. Bruggink-Andre, A. van Bujisen-Nutters, Ziekenhuis, M. Daniels, A. Coppes, M. van Zagten, N. Elzebroek, K. Hamroui, P. de Kort, J. Vuijsters, N. Holwerda, W. Hermans, R. van der Loo, E. Wajon, G. Hageman, G. Buchem-Damming, E. Ronner, A. Wissenburg-van Lieshout, H. Niekus, M. W. van Hessen, G. A. Verheul, G. Linssen, L. te Pas, J. Plomp, P. A. de Milliano, R. Breedveld, M. J. Bos, M. Houra, D. Beran, R. Lebedova, J. Carda, E. Bednarova, J. Vosmerova, G. Marcinek, T. Drasnar, O. Najmanova, M. Dunaj, E. Pechackova, M. Kuchar, P. Jansky, J. Simon, H. Dvorakova, P. Gregor, M. Maruskova, L. Svoboda, Z. Lorenc, P. Kralicek, L. Pollak, M. Krobot, J. Spinar, M. Nemec, L. Spinarova, R. Kuba, F. Padour, I. Padourova, M. Padour, M. Michalova, L. Golan, M. Hajkova, J. Povolny, L. Krizova, D. Horak, P. Kucera, I. Malek, B. Krizova, J. Svoboda, R. Ferkl, L. Regos, L. Csuros, O. Lovasz, G. Kiss, S. Timar, N. Torok, A. Hajnalne, B. Palossy, A. Nagy, P. Fulop, G. Jakab, A. Ronaszeki, M. Bodi, M. Satori, I. Edes, I. Varga, A. Kovacs, L. Berente, E. Péterfai, R. Pauer, K. Toth, E. Nagy, B. Benczur, K. Karsay, T. Végh, R. Nagy, P. Karpati, Z. Davidovits, J. Borbola, J. Vanyi, B. Oze, A. Bujdoso, I. Kosa, L. Baliko, M. Natour, M. Morgil, E. Hartmann, H. Morgil, R. Winkler, S. Gass, S. Baumann, M. Jeserich, J. Rodl, M. Dzaiy, G. Turhan, K. Wolf, S. Genth-Zotz, T. Siebert, C. Jakobs, M. Kiorwantsi, B. Pieske, R. Wachter, M. Schoenauer, S. Voigt, H. Schunkert, A. Boguschewski, M. Resch, R. Wensel, V. Schumann, P. Heidrich, O. Girina, Y. Prokopovych, M. Lebedynska, I. Sorokina, O. Karpenko, N. Brodi, S. Klochkov, L. Voronkov, Y. Besaga, O. Novikova, K. Amosova, O. Yaremenko, K. Balaban, V. Kovalenko, N. Polenova, I. Sakharchuk, A. Ogorodnichuk, L. Rudenko, Y. Tutov, A. Parkhomenko, S. Kozhukhov, E. Yakimenko, S. Kolomiets, V. Yurlov, S. Tikhonova, A. Elizalde, B. Mangariello, C. Zaidman, F. Guerlloy, P. Gitelman, K. Crotto, S. Sassone, J. Aiub, F. Novoa, R. Lopez Santi, P. Romia, O. Montaña, D. Malchik, F. Sokn, P. Schygiel, R. Porcile, F. Soria Tito, J. Thierer, P. Avellana, C. Rapallo, M. Calderon, R. MacFadyen, R. Haynes, J. Partridge, L. Dérera, M. Kokles, S. Mehešová, A. Zachar, M. Hranai, T. Varadyova, T. Göbö, J. Litvinova, P. Loviska

Research output: Contribution to journalArticle

8 Scopus citations

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 (US)
Article numbere113447
JournalPloS one
Volume9
Issue number11
DOIs
StatePublished - Nov 26 2014

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ASJC Scopus subject areas

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

Cite this

Graham, S., Ye, S., Qian, M., Sanford, A. R., Tullio, M. R. D., Sacco, R. L., Mann, D. L., Levin, B., Pullicino, P. M., Freudenberger, R. S., Teerlink, J. R., Mohr, J. P., Labovitz, A. J., Lip, G. Y. H., Estol, C. J., Lok, D. J., Ponikowski, P., Anker, S. D., Thompson, J. L. P., ... Loviska, P. (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, 9(11), [e113447]. https://doi.org/10.1371/journal.pone.0113447