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Volume 2 Journal of Clinical Diagnosis and Treatment Annual Nephrology & Chronic Diseases 2019
May 20-21, 2019
Nephrology
Chronic Diseases May 20-21, 2019 London, UK
19th Annual Conference on
3rd International Conference on
&
Prognostic value of Montreal cognitive assessment in heart failure patients
Lyu Siqi and Yu Litian
Peking Union Medical College, China
Objective: To explore the occurrence of cognitive impairment in Chinese heart failure (HF) patients and its
impact on prognosis.
Methods: A total of 990 patients were enrolled from 24 hospitals in China during December 2012 to
November 2014. All patients were administrated with the interview-format MoCA, according to which
they were divided into MoCA＜26 group and MoCA≥26 group. Baseline data were collected and a 1-year
follow-up was carried out. Univariate and multivariate Cox regression were performed for 1-year outcomes.
Results: 628 patients (63.4%) had cognitive impairment and they were more likely to be older, female,
less educated, uninsured and New York Heart Association class III-IV. Compared with MoCA≥26 group,
the rate of intervention, device implantation, cardiac surgery and evidence-based medications were
significantly lower in MoCA＜ 26 group (all p＜0.05). As to the 1-year outcomes, MoCA＜26 group had
higher all-cause mortality (10.2% vs. 2.2%, p<0.001), cardiovascular mortality (5.9% vs. 0.8%, p<0.001) and
major cardiovascular events (MACE) (9.6% vs. 2.5%, p<0.001) than MoCA≥26 group. After adjustment
by multivariate regression, MoCA ＜26 was indicated as a significant risk factor for all-cause mortality
[HR(95 ％CI): 4.212(1.987-8.927), p<0.001], cardiovascular mortality [HR(95 ％CI): 7.632(2.316-25.147),
p=0.001] and MACE [OR(95％CI): 4.229(2.006-8.914), p<0.001], while not for hospitalization for HF.
Conclusion: Cognitive impairment was common in HF patients and was identified as an independent
prognostic marker for 1-year outcomes. Routine cognitive function assessment and active intervention are
recommended for HF patients.
J Clinical Diagnosis and Treatment, Volume 2