Journal of the American Heart Association · 2025
Association of Dementia With the Outcome of Patients With Heart Failure: Evidence From the Japanese KCHF Registry.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Yamamoto Erika, Kato Takao, Morimoto Takeshi, Yaku Hidenori, Inuzuka Yasutaka, Tamaki Yodo, Ozasa Neiko, Yoshikawa Yusuke, Kitai Takeshi, Taniguchi Ryoji, Iguchi Moritake, Nagao Kazuya, Nishikawa Ryusuke, Kawase Yuichi, Furukawa Yutaka, Ando Kenji, Kadota Kazushige, Shizuta Satoshi, Sato Yukihito, Kuwahara Koichiro, Kimura Takeshi, Ono Koh, KCHF study investigators
Аннотация
BACKGROUND: Patients with heart failure (HF) have a significantly higher prevalence of cognitive impairment than those without HF. While the association of dementia with prognosis of patients with HF is well documented in Western populations, data from large, prospective cohorts in East Asia, particularly Japan, remain limited.
METHODS: The KCHF (Kyoto Congestive Heart Failure) registry, a prospective cohort study, enrolled consecutive patients admitted for acute decompensated HF in Japan. We evaluated 3728 patients who were alive at discharge and for whom follow-up data were available. We compared 1-year clinical outcomes between patients with and without dementia.
RESULTS: Of 3728 participants, 658 (17.6%) were diagnosed with dementia. Patients with dementia were older, more likely to be men, more often had atrial fibrillation and prior stroke with poorer daily life activities and poor adherence to medical therapy, and less often received guideline-directed medications at discharge than those without dementia. After adjustment for confounders, the excess risk of patients with dementia compared with those without dementia remained significant for all-cause death and cardiovascular death (hazard ratio [HR], 1.45 [95% CI, 1.17-1.79]; P=0.0007; HR, 1.48 [95% CI, 1.12-1.95]; P=0.006, respectively). However, the excess risk of patients with dementia compared with those without dementia was no longer significant for noncardiovascular death and HF hospitalization (HR, 1.36 [95% CI, 0.96-1.91]; P=0.08; HR, 1.08 [95% CI, 0.88-1.33]; P=0.45, respectively).
CONCLUSIONS: Dementia in patients with HF is associated with the risk for all-cause death as well as cardiovascular death.
METHODS: The KCHF (Kyoto Congestive Heart Failure) registry, a prospective cohort study, enrolled consecutive patients admitted for acute decompensated HF in Japan. We evaluated 3728 patients who were alive at discharge and for whom follow-up data were available. We compared 1-year clinical outcomes between patients with and without dementia.
RESULTS: Of 3728 participants, 658 (17.6%) were diagnosed with dementia. Patients with dementia were older, more likely to be men, more often had atrial fibrillation and prior stroke with poorer daily life activities and poor adherence to medical therapy, and less often received guideline-directed medications at discharge than those without dementia. After adjustment for confounders, the excess risk of patients with dementia compared with those without dementia remained significant for all-cause death and cardiovascular death (hazard ratio [HR], 1.45 [95% CI, 1.17-1.79]; P=0.0007; HR, 1.48 [95% CI, 1.12-1.95]; P=0.006, respectively). However, the excess risk of patients with dementia compared with those without dementia was no longer significant for noncardiovascular death and HF hospitalization (HR, 1.36 [95% CI, 0.96-1.91]; P=0.08; HR, 1.08 [95% CI, 0.88-1.33]; P=0.45, respectively).
CONCLUSIONS: Dementia in patients with HF is associated with the risk for all-cause death as well as cardiovascular death.