Heart failure & cardiomyopathiesSecondary analysis
Clinical Correlates and Prognostic Impact of Cognitive Dysfunction in Patients With Heart Failure and Preserved Ejection Fraction: Insights From PARAGON-HF
- Secondary analysis of the PARAGON-HF randomised trial
- prespecified substudy
Authors' conclusion
In patients with heart failure and preserved ejection fraction, even modest baseline impairment of cognitive function was associated with worse outcomes, including death. A decline in MMSE score during follow-up was a strong predictor of mortality, independent of other prognostic variables.
Study context
- Population
- Patients with HFpEF in the PARAGON-HF trial
- Participants
- 2,895 patients
- Comparison
- Baseline Mini-Mental State Examination (MMSE) categories
- Normaln = 1,809reference
- Borderlinen = 794
- Impairedn = 292
- Primary endpoint
- Composite of:
- Time to first HF hospitalization
- CV death
Primary result
As reported in the abstract
First HF hospitalization or CV death
Each group vs normalAdjusted hazard ratio (95% CI)
Borderline
1.27(1.06–1.53)
Impaired
1.58(1.21–2.06)
Further findings
Individual components of the composite and all-cause death
- Associations also found for individual components and all-cause death
Total (first and repeat) HF hospitalizations and CV deaths
- Cognitive impairment associated with higher risk
- 50%
Decline in MMSE score during follow-up and death
- Decrease in MMSE score associated with higher risk of death
Variables associated with lower baseline MMSE and decline in score · 48 weeks
- Older age, history of stroke or TIA, lower serum albumin
Original publication
Clinical Correlates and Prognostic Impact of Cognitive Dysfunction in Patients With Heart Failure and Preserved Ejection Fraction: Insights From PARAGON-HF. Circulation. Published 21 October 2024. doi:10.1161/circulationaha.124.070553
Summarised from the published abstract; every number is checked against it