Baseline characteristics of patients with heart failure and mild cognitive impairment in Cog-HF trial

Dementia and heart failure (HF) are two major epidemics that adversely influence each other, yet few studies have explored strategies to prevent cognitive decline in HF. The Reducing Cognitive impairment by management of Heart Failure as a Modifiable Risk Factor (Cog-HF) trial is a randomized controlled trial assessing whether a disease management program (DMP) compared to usual care can mitigate cognitive decline in HF patients with mild cognitive impairment (MCI). This report describes the baseline characteristics of patients enrolled in Cog-HF and their comparability to recent Japanese HF registries.

Patients with HF and MCI, defined as a Montreal Cognitive Assessment (MoCA) <26, were recruited for Cog-HF. Baseline characteristics of patients in Cog-HF were compared to those of the FRAGILE-HF, JROADHF, and CURE-HF cohorts.

Among 176 participants (mean age 79 ± 6 years; 53 % men; body mass index 22.3 ± 3.4 kg/m²), prevalence of hypertension, atrial fibrillation, coronary artery disease, and chronic obstructive pulmonary disease was 68 %, 46 %, 25 %, and 7 %, respectively. Most patients had a preserved ejection fraction (HFpEF, 74 %), were in New York Heart Association class II (61 %), and exhibited lower rates of physical (50 %) and social frailty (35 %). The Cog-HF cohort had similarly high rates of background medical therapy (69 % angiotensin-converting enzyme inhibitor/angiotensin receptor blocker/angiotensin receptor-neprilysin inhibitors, 51 % mineralocorticoid receptor antagonists, and 66 % beta blockers), with a higher rate of sodium glucose cotransporter 2 inhibitors (56 %) compared to those in recent registries.

Patients in Cog-HF were similar to those in recent HF registries and were receiving guideline-recommended HF treatment, supporting the external validity of future trial findings.