Association of Dementia With the Outcome of Patients With Heart Failure: Evidence From the Japanese KCHF Registry.

backgroundPatients 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.

methodsThe 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.

resultsOf 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];

conclusionsDementia in patients with HF is associated with the risk for all-cause death as well as cardiovascular death.