Usefulness of cognitive dysfunction in heart failure to predict cardiovascular risk at 180 days

Area of Science:

• Cardiology
• Neuropsychology
• Clinical Medicine

Background:

• Cognitive dysfunction is prevalent in heart failure (HF) patients.
• The prognostic impact of cognitive dysfunction in HF is not well understood.
• Early identification of cognitive impairment is crucial for managing HF patients.

Purpose of the Study:

• To investigate the association between cognitive dysfunction, assessed by the Montreal Cognitive Assessment (MoCA), and 180-day cardiovascular event risk in HF patients.
• To determine if MoCA scores can serve as a predictor of adverse cardiovascular outcomes in this population.

Main Methods:

• An observational cohort study included 246 adult HF patients.
• The interview-format Montreal Cognitive Assessment (MoCA) was used to identify cognitive dysfunction (score <26).
• Cox proportional hazards models analyzed time to the first cardiovascular event within 180 days, adjusting for clinical risk scores.

Main Results:

• 37% of participants (91 patients) had a MoCA score below 26, indicating cognitive dysfunction.
• Patients with MoCA scores <26 had a significantly higher likelihood of experiencing a cardiovascular event within 180 days.
• A MoCA score <26 independently predicted cardiovascular event risk (HR 1.7, 95% CI 1.1-2.6, p=0.03) after adjusting for established risk models.

Conclusions:

• Cognitive dysfunction, identified by a MoCA score <26, is a significant independent predictor of 180-day cardiovascular events in heart failure patients.
• The MoCA assessment can aid in identifying HF patients at higher risk for adverse cardiovascular outcomes.
• Integrating cognitive screening into HF management may improve patient prognostication and care.