PMID- 32135614
OWN - NLM
STAT- MEDLINE
DCOM- 20200310
LR  - 20200310
IS  - 0253-3758 (Print)
IS  - 0253-3758 (Linking)
VI  - 48
IP  - 2
DP  - 2020 Feb 24
TI  - [Prognostic value of Montreal Cognitive Assessment in heart failure patients].
PG  - 136-141
LID - 10.3760/cma.j.issn.0253-3758.2020.02.009 [doi]
AB  - Objective: To explore the occurrence of cognitive impairment in Chinese heart 
      failure (HF) patients and it's impact on prognosis. Methods: In this prospective 
      observational study, a total of 990 HF patients were enrolled from 24 hospitals 
      in China during December 2012 to November 2014. All patients were administrated 
      with the interview-format Montreal Cognitive Assessment (MoCA), according to 
      which they were divided into MoCA<26 (with cognitive impairment) group and 
      MoCA>/=26 (without cognitive impairment) group. Baseline data were collected and a 
      1-year follow up was carried out. Univariate and multivariate logistic or Cox 
      regression were performed for 1-year outcomes. Results: Cognitive impairment was 
      evidenced in 628 patients (63.4%) and they were more likely to be older, female, 
      and with higher proportion of New York Heart Association(NYHA) class Ⅲ-Ⅳ, chronic 
      obstructive pulmonary disease (COPD), ischemic heart disease, while body mass 
      index (BMI), education level, and medical insurance rate were lower (all P<0.05) 
      as compared to patients in MoCA>/=26 group. The rate of percutaneous intervention, 
      device implantation, cardiac surgery and evidence-based medications were 
      significantly lower in MoCA<26 group than in MoCA>/=26 group (all P<0.05). During 
      the 1-year follow up, patients in the MoCA<26 group had higher all-cause 
      mortality (10.2%(64/628) vs. 2.2%(8/362), P<0.01), cardiovascular mortality 
      (5.9%(37/628) vs. 0.8%(3/362), P<0.01) and major adverse cardiac and 
      cerebrovascular events (MACCE) (9.6%(60/628) vs. 2.5%(8/362), P<0.01) than 
      patients in the MoCA>/=26 group. In univariate regression, MoCA<26 was associated 
      with increased all-cause mortality (HR(95%CI):4.739(2.272-9.885), P<0.01), 
      cardiovascular mortality (HR(95%CI):7.258(2.237-23.548), P=0.001) and MACCE 
      (OR(95%CI):4.143(2.031-8.453), P<0.01). After adjustment by multivariate 
      regression, MoCA<26 was indicated as an independent risk factor for all-cause 
      mortality (HR(95%CI): 6.387(2.533-16.104), P<0.01), cardiovascular mortality 
      (HR(95%CI): 10.848(2.586-45.506), P=0.001) and MACCE (OR(95%CI): 
      4.081(1.299-12.816), P=0.016), while not for re-hospitalization for HF 
      (OR(95%CI):1.010(0.700-1.457), P=0.957). Conclusions: Cognitive impairment is 
      common in HF patients,and it is an independent prognostic factor for 1-year 
      outcomes. Routine cognitive function assessment and active intervention are thus 
      recommended for HF patients.
FAU - Lyu, S S
AU  - Lyu SS
AD  - Emergency and Critical Care Center, Fuwai Hospital, National Center for 
      Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union 
      Medical College, Beijing 100037, China.
FAU - Tan, H Q
AU  - Tan HQ
FAU - Liu, S S
AU  - Liu SS
FAU - Liu, X N
AU  - Liu XN
FAU - Guo, X
AU  - Guo X
FAU - Gao, D F
AU  - Gao DF
FAU - Mo, R
AU  - Mo R
FAU - Zhu, J
AU  - Zhu J
FAU - Yu, L T
AU  - Yu LT
LA  - chi
PT  - Journal Article
PT  - Observational Study
PL  - China
TA  - Zhonghua Xin Xue Guan Bing Za Zhi
JT  - Zhonghua xin xue guan bing za zhi
JID - 7910682
SB  - IM
MH  - China
MH  - Female
MH  - *Heart Failure
MH  - Humans
MH  - Mental Status and Dementia Tests
MH  - Prognosis
MH  - Prospective Studies
OTO - NOTNLM
OT  - Cognition disorders
OT  - Heart failure
OT  - Montreal Cognitive Assessment
OT  - Prognosis
EDAT- 2020/03/07 06:00
MHDA- 2020/03/11 06:00
CRDT- 2020/03/06 06:00
PHST- 2020/03/06 06:00 [entrez]
PHST- 2020/03/07 06:00 [pubmed]
PHST- 2020/03/11 06:00 [medline]
AID - 10.3760/cma.j.issn.0253-3758.2020.02.009 [doi]
PST - ppublish
SO  - Zhonghua Xin Xue Guan Bing Za Zhi. 2020 Feb 24;48(2):136-141. doi: 
      10.3760/cma.j.issn.0253-3758.2020.02.009.