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; S. 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

doi:10.1371/journal.pone.0113447

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 journal › Article › peer-review

14 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 language	English (US)
Article number	e113447
Journal	PloS one
Volume	9
Issue number	11
DOIs	https://doi.org/10.1371/journal.pone.0113447
State	Published - Nov 26 2014
Externally published	Yes

ASJC Scopus subject areas

General

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10.1371/journal.pone.0113447

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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), Article e113447. https://doi.org/10.1371/journal.pone.0113447

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, Ammon, S, Massie, B, Moy, C, Gilbert, P, Gutmann, L, Marler, J, Mejia, V, Gabriel, A, Czaja, P, Gaciong, Z, Gora, J, Kleinrok, A, Prokop-Lewicka, G, Haddad, H, Davies, R, Sitwell, L, Donaldson, J, To, T, Yufe, R, Donelly, B, Huynh, T, Cote, R, St Jacques, B, Borts, D, Sindilar, AM, Winder, T, Janzen, E, Walker, C, Moe, G, Bayer, N, Konig, A, Arnold, M, Spence, D, Smith, J, Bessoudo, R, Bailey, P, McNulty, A, Nawaz, S, Dewar, C, Rajda, M, MacFarlane, M, Minuk, J, Schanz, C, Penn, A, Atkins, L, Ducharme, A, Brown, H, Zieroth, S, Muñoz, A, ten Holter, JB, Huls, C, Bruggink-Andre, P, van Bujisen-Nutters, A, Ziekenhuis, Daniels, M, Coppes, A, van Zagten, M, Elzebroek, N, Hamroui, K, de Kort, P, Vuijsters, J, Holwerda, N, Hermans, W, van der Loo, R, Wajon, E, Hageman, G, Buchem-Damming, G, Ronner, E, Wissenburg-van Lieshout, A, Niekus, H, van Hessen, MW, Verheul, GA, Linssen, G, te Pas, L, Plomp, J, de Milliano, PA, Breedveld, R, Bos, MJ, Houra, M, Beran, D, Lebedova, R, Carda, J, Bednarova, E, Vosmerova, J, Marcinek, G, Drasnar, T, Najmanova, O, Dunaj, M, Pechackova, E, Kuchar, M, Jansky, P, Simon, J, Dvorakova, H, Gregor, P, Maruskova, M, Svoboda, L, Lorenc, Z, Kralicek, P, Pollak, L, Krobot, M, Spinar, J, Nemec, M, Spinarova, L, Kuba, R, Padour, F, Padourova, I, Padour, M, Michalova, M, Golan, L, Hajkova, M, Povolny, J, Krizova, L, Horak, D, Kucera, P, Malek, I, Krizova, B, Svoboda, J, Ferkl, R, Regos, L, Csuros, L, Lovasz, O, Kiss, G, Timar, S, Torok, N, Hajnalne, A, Palossy, B, Nagy, A, Fulop, P, Jakab, G, Ronaszeki, A, Bodi, M, Satori, M, Edes, I, Varga, I, Kovacs, A, Berente, L, Péterfai, E, Pauer, R, Toth, K, Nagy, E, Benczur, B, Karsay, K, Végh, T, Nagy, R, Karpati, P, Davidovits, Z, Borbola, J, Vanyi, J, Oze, B, Bujdoso, A, Kosa, I, Baliko, L, Natour, M, Morgil, M, Hartmann, E, Morgil, H, Winkler, R, Gass, S, Baumann, S, Jeserich, M, Rodl, J, Dzaiy, M, Turhan, G, Wolf, K, Genth-Zotz, S, Siebert, T, Jakobs, C, Kiorwantsi, M, Pieske, B, Wachter, R, Schoenauer, M, Voigt, S, Schunkert, H, Boguschewski, A, Resch, M, Wensel, R, Schumann, V, Heidrich, P, Girina, O, Prokopovych, Y, Lebedynska, M, Sorokina, I, Karpenko, O, Brodi, N, Klochkov, S, Voronkov, L, Besaga, Y, Novikova, O, Amosova, K, Yaremenko, O, Balaban, K, Kovalenko, V, Polenova, N, Sakharchuk, I, Ogorodnichuk, A, Rudenko, L, Tutov, Y, Parkhomenko, A, Kozhukhov, S, Yakimenko, E, Kolomiets, S, Yurlov, V, Tikhonova, S, Elizalde, A, Mangariello, B, Zaidman, C, Guerlloy, F, Gitelman, P, Crotto, K, Sassone, S, Aiub, J, Novoa, F, Lopez Santi, R, Romia, P, Montaña, O, Malchik, D, Sokn, F, Schygiel, P, Porcile, R, Soria Tito, F, Thierer, J, Avellana, P, Rapallo, C, Calderon, M, MacFadyen, R, Haynes, R, Partridge, J, Dérera, L, Kokles, M, Mehešová, S, Zachar, A, Hranai, M, Varadyova, T, Göbö, T, Litvinova, J & 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, vol. 9, no. 11, e113447. https://doi.org/10.1371/journal.pone.0113447

@article{7ce3d40b5b1f44e78cc07a4862b7561b,

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

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.",

author = "Susan Graham and Siqin Ye and Min Qian and Sanford, {Alexra R.} and Tullio, {Marco R.Di} and Sacco, {Ralph L.} and Mann, {Douglas L.} and Bruce Levin and Pullicino, {Patrick M.} and Freudenberger, {Ronald S.} and Teerlink, {John R.} and Mohr, {J. P.} and Labovitz, {Arthur J.} and Lip, {Gregory Y.H.} and Estol, {Conrado J.} and Lok, {Dirk J.} and Piotr Ponikowski and Anker, {Stefan D.} and Thompson, {John L.P.} and Shunichi Homma and S. Ammon and B. Massie and C. Moy and P. Gilbert and L. Gutmann and J. Marler and V. Mejia and A. Gabriel and P. Czaja and Z. Gaciong and J. Gora and A. Kleinrok and G. Prokop-Lewicka and H. Haddad and R. Davies and L. Sitwell and J. Donaldson and T. To and R. Yufe and B. Donelly and T. Huynh and R. Cote and {St Jacques}, B. and D. Borts and Sindilar, {A. M.} and T. Winder and E. Janzen and C. Walker and G. Moe and N. Bayer and A. Konig and M. Arnold and D. Spence and J. Smith and R. Bessoudo and P. Bailey and A. McNulty and S. Nawaz and C. Dewar and M. Rajda and M. MacFarlane and J. Minuk and C. Schanz and A. Penn and L. Atkins and A. Ducharme and H. Brown and S. Zieroth and A. Mu{\~n}oz and {ten Holter}, {J. B.} and C. Huls and P. Bruggink-Andre and {van Bujisen-Nutters}, A. and Ziekenhuis and M. Daniels and A. Coppes and {van Zagten}, M. and N. Elzebroek and K. Hamroui and {de Kort}, P. and J. Vuijsters and N. Holwerda and W. Hermans and {van der Loo}, R. and E. Wajon and G. Hageman and G. Buchem-Damming and E. Ronner and {Wissenburg-van Lieshout}, A. and H. Niekus and {van Hessen}, {M. W.} and Verheul, {G. A.} and G. Linssen and {te Pas}, L. and J. Plomp and {de Milliano}, {P. A.} and R. Breedveld and Bos, {M. J.} and M. Houra and D. Beran and R. Lebedova and J. Carda and E. Bednarova and J. Vosmerova and G. Marcinek and T. Drasnar and O. Najmanova and M. Dunaj and E. Pechackova and M. Kuchar and P. Jansky and J. Simon and H. Dvorakova and P. Gregor and M. Maruskova and L. Svoboda and Z. Lorenc and P. Kralicek and L. Pollak and M. Krobot and J. Spinar and M. Nemec and L. Spinarova and R. Kuba and F. Padour and I. Padourova and M. Padour and M. Michalova and L. Golan and M. Hajkova and J. Povolny and L. Krizova and D. Horak and P. Kucera and I. Malek and B. Krizova and J. Svoboda and R. Ferkl and L. Regos and L. Csuros and O. Lovasz and G. Kiss and S. Timar and N. Torok and A. Hajnalne and B. Palossy and A. Nagy and P. Fulop and G. Jakab and A. Ronaszeki and M. Bodi and M. Satori and I. Edes and I. Varga and A. Kovacs and L. Berente and E. P{\'e}terfai and R. Pauer and K. Toth and E. Nagy and B. Benczur and K. Karsay and T. V{\'e}gh and R. Nagy and P. Karpati and Z. Davidovits and J. Borbola and J. Vanyi and B. Oze and A. Bujdoso and I. Kosa and L. Baliko and M. Natour and M. Morgil and E. Hartmann and H. Morgil and R. Winkler and S. Gass and S. Baumann and M. Jeserich and J. Rodl and M. Dzaiy and G. Turhan and K. Wolf and S. Genth-Zotz and T. Siebert and C. Jakobs and M. Kiorwantsi and B. Pieske and R. Wachter and M. Schoenauer and S. Voigt and H. Schunkert and A. Boguschewski and M. Resch and R. Wensel and V. Schumann and P. Heidrich and O. Girina and Y. Prokopovych and M. Lebedynska and I. Sorokina and O. Karpenko and N. Brodi and S. Klochkov and L. Voronkov and Y. Besaga and O. Novikova and K. Amosova and O. Yaremenko and K. Balaban and V. Kovalenko and N. Polenova and I. Sakharchuk and A. Ogorodnichuk and L. Rudenko and Y. Tutov and A. Parkhomenko and S. Kozhukhov and E. Yakimenko and S. Kolomiets and V. Yurlov and S. Tikhonova and A. Elizalde and B. Mangariello and C. Zaidman and F. Guerlloy and P. Gitelman and K. Crotto and S. Sassone and J. Aiub and F. Novoa and {Lopez Santi}, R. and P. Romia and O. Monta{\~n}a and D. Malchik and F. Sokn and P. Schygiel and R. Porcile and {Soria Tito}, F. and J. Thierer and P. Avellana and C. Rapallo and M. Calderon and R. MacFadyen and R. Haynes and J. Partridge and L. D{\'e}rera and M. Kokles and S. Mehe{\v s}ov{\'a} and A. Zachar and M. Hranai and T. Varadyova and T. G{\"o}b{\"o} and J. Litvinova and P. Loviska",

note = "Publisher Copyright: {\textcopyright} 2014 Graham et al.",

year = "2014",

month = nov,

day = "26",

doi = "10.1371/journal.pone.0113447",

language = "English (US)",

volume = "9",

journal = "PloS one",

issn = "1932-6203",

publisher = "Public Library of Science",

number = "11",

}

TY - JOUR

T1 - Cognitive function in ambulatory patients with systolic heart failure

T2 - Insights from the warfarin versus aspirin in reduced cardiac ejection fraction (warcef) trial

AU - Graham, Susan

AU - Ye, Siqin

AU - Qian, Min

AU - Sanford, Alexra R.

AU - Tullio, Marco R.Di

AU - Sacco, Ralph L.

AU - Mann, Douglas L.

AU - Levin, Bruce

AU - Pullicino, Patrick M.

AU - Freudenberger, Ronald S.

AU - Teerlink, John R.

AU - Mohr, J. P.

AU - Labovitz, Arthur J.

AU - Lip, Gregory Y.H.

AU - Estol, Conrado J.

AU - Lok, Dirk J.

AU - Ponikowski, Piotr

AU - Anker, Stefan D.

AU - Thompson, John L.P.

AU - Homma, Shunichi

AU - Ammon, S.

AU - Massie, B.

AU - Moy, C.

AU - Gilbert, P.

AU - Gutmann, L.

AU - Marler, J.

AU - Mejia, V.

AU - Gabriel, A.

AU - Czaja, P.

AU - Gaciong, Z.

AU - Gora, J.

AU - Kleinrok, A.

AU - Prokop-Lewicka, G.

AU - Haddad, H.

AU - Davies, R.

AU - Sitwell, L.

AU - Donaldson, J.

AU - To, T.

AU - Yufe, R.

AU - Donelly, B.

AU - Huynh, T.

AU - Cote, R.

AU - St Jacques, B.

AU - Borts, D.

AU - Sindilar, A. M.

AU - Winder, T.

AU - Janzen, E.

AU - Walker, C.

AU - Moe, G.

AU - Bayer, N.

AU - Konig, A.

AU - Arnold, M.

AU - Spence, D.

AU - Smith, J.

AU - Bessoudo, R.

AU - Bailey, P.

AU - McNulty, A.

AU - Nawaz, S.

AU - Dewar, C.

AU - Rajda, M.

AU - MacFarlane, M.

AU - Minuk, J.

AU - Schanz, C.

AU - Penn, A.

AU - Atkins, L.

AU - Ducharme, A.

AU - Brown, H.

AU - Zieroth, S.

AU - Muñoz, A.

AU - ten Holter, J. B.

AU - Huls, C.

AU - Bruggink-Andre, P.

AU - van Bujisen-Nutters, A.

AU - Ziekenhuis,

AU - Daniels, M.

AU - Coppes, A.

AU - van Zagten, M.

AU - Elzebroek, N.

AU - Hamroui, K.

AU - de Kort, P.

AU - Vuijsters, J.

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PY - 2014/11/26

Y1 - 2014/11/26

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=84913534806&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84913534806&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0113447

DO - 10.1371/journal.pone.0113447

M3 - Article

C2 - 25426862

AN - SCOPUS:84913534806

SN - 1932-6203

VL - 9

JO - PloS one

JF - PloS one

IS - 11

M1 - e113447

ER -

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

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