Evidence map›Paper›PMID 31779926›Full record

ArticleJACC. Heart failure2019

Cognitive Decline Over Time in Patients With Systolic Heart Failure: Insights From WARCEF.

Tetz C Lee, Min Qian, Yutong Liu, Susan Graham, Douglas L Mann, Koki Nakanishi, John R Teerlink, Gregory Y H Lip, Ronald S Freudenberger, Ralph L Sacco and 14 more

Registry-linked trialOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. Heart failure, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00041938 (Warfarin Versus Aspirin in Reduced Cardiac Ejection Fraction), which is not on this map. Cited by 24 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 1 pooled it
2.6field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00041938 phase3completednot on this map

Warfarin Versus Aspirin in Reduced Cardiac Ejection Fraction (WARCEF) Trial

TypeinterventionalSponsorColumbia UniversityRan2002 to 2014Enrolled2,305ConditionsHeart Disease, Stroke, Ischemic Heart Disease, Myocardial InfarctionArmsaspirin, Warfarin
3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 1 synthesis or guideline pooled it, 42 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

24 authors at 10 institutions in 6 countries.

Tetz C LeeColumbia University Medical Center, New York, NY.
Min QianColumbia University Medical Center, New York, NY.
Yutong LiuColumbia University Medical Center, New York, NY.
Susan GrahamDepartment of Medicine, State University of New York at Buffalo, Buffalo, New York.
Douglas L MannDepartment of Medicine, Washington University School of Medicine, St. Louis, Missouri.
Koki NakanishiColumbia University Medical Center, New York, NY.
John R TeerlinkSection of Cardiology, San Francisco Veterans Affairs Medical Center and School of Medicine, University of California San Francisco, San Francisco, California.
Gregory Y H LipLiverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom; Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Ronald S FreudenbergerLehigh Valley Hospital, Allentown, Pennsylvania.
Ralph L SaccoDepartment of Neurology, University of Miami, Miami, Florida.
Jay P MohrColumbia University Medical Center, New York, NY.
Arthur J LabovitzDepartment of Medicine, University of South Florida, Tampa, Florida.
Piotr PonikowskiMilitary Hospital, Wroclaw, Poland.
Dirk J LokDeventer Hospital, Deventer, the Netherlands.
Kenji MatsumotoColumbia University Medical Center, New York, NY.
Conrado EstolStroke Unit, Sanatorio Guemes, Buenos Aires, Argentina.
Stefan D AnkerDivision of Cardiology and Metabolism, Department of Cardiology, and Berlin-Brandenburg Center for Regenerative Therapies, Deutsches Zentrum für Herz-Kreislauf-Forschung partner site Berlin; Charité Universitätsmedizin Berlin, Germany; Department of Cardiology and Pneumology, University Medicine Göttingen, Göttingen, Germany.
Patrick M PullicinoKent Institute of Medicine and Health Science, Canterbury, United Kingdom.
Richard BuchsbaumColumbia University Medical Center, New York, NY.
Bruce LevinColumbia University Medical Center, New York, NY.
John L P ThompsonColumbia University Medical Center, New York, NY.
Shunichi HommaColumbia University Medical Center, New York, NY.
Marco R Di TullioColumbia University Medical Center, New York, NY. Electronic address: md42@cumc.columbia.edu.
WARCEF Investigators
Columbia University Irving Medical Center · USDeventer Ziekenhuis · NLHelios Salud · ARLehigh Valley Hospital-Pocono · USSan Francisco VA Medical Center · USUniversitätsmedizin Göttingen · DEUniversity of Liverpool · GBUniversity of Miami · USUniversity of South Florida · USWashington University in St. Louis · US

Funding

Warfarin vs. Aspirin in Reduced Ejection Fraction (WARCEF)U01NS043975 · NINDS · UNIV OF MED/DENT OF NJ-NJ MEDICAL SCHOOL · PI HOMMA, SHUNICHI · 2001 to 2010
$43.3M
Clinical and Translational Science Collaborative of ClevelandUL1TR002548 · NCATS · CASE WESTERN RESERVE UNIVERSITY · PI MCCOMSEY, GRACE A · 2018 to 2022
$35.5M
Warfarin vs Aspirin in Reduced Ejection Fraction -STATU01NS039143 · NINDS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI THOMPSON, JOHN L · 2001 to 2010
$21.3M
NCATS NIH HHS UL1 TR002548NINDS NIH HHS U01 NS039143NINDS NIH HHS U01 NS043975
6 · The paper itself

Abstract

objectivesThis study sought to characterize cognitive decline (CD) over time and its predictors in patients with systolic heart failure (HF).

backgroundDespite the high prevalence of CD and its impact on mortality, predictors of CD in HF have not been established.

methodsThis study investigated CD in the WARCEF (Warfarin versus Aspirin in Reduced Ejection Fraction) trial, which performed yearly Mini-Mental State Examinations (MMSE) (higher scores indicate better cognitive function; e.g., normal score: 24 or higher). A longitudinal time-varying analysis was performed among pertinent covariates, including baseline MMSE and MMSE scores during follow-up, analyzed both as a continuous variable and a 2-point decrease. To account for a loss to follow-up, data at the baseline and at the 12-month visit were analyzed separately (sensitivity analysis).

resultsA total of 1,846 patients were included. In linear regression, MMSE decrease was independently associated with higher baseline MMSE score (p < 0.0001), older age (p < 0.0001), nonwhite race/ethnicity (p < 0.0001), and lower education (p < 0.0001). In logistic regression, CD was independently associated with higher baseline MMSE scores (odds ratio [OR]: 1.13; 95% confidence interval [CI]: 1.07 to 1.20]; p < 0.001), older age (OR: 1.37; 95% CI: 1.24 to 1.50; p < 0.001), nonwhite race/ethnicity (OR: 2.32; 95% CI: 1.72 to 3.13 for black; OR: 1.94; 95% CI: 1.40 to 2.69 for Hispanic vs. white; p < 0.001), lower education (p < 0.001), and New York Heart Association functional class II or higher (p = 0.03). Warfarin and other medications were not associated with CD. Similar trends were seen in the sensitivity analysis (n = 1,439).

conclusionsCD in HF is predicted by baseline cognitive status, demographic variables, and NYHA functional class. The possibility of intervening on some of its predictors suggests the need for the frequent assessment of cognitive function in patients with HF. (Warfarin versus Aspirin in Reduced Cardiac Ejection Fraction [WARCEF]; NCT00041938).

Indexed as

AgedAnticoagulantsAspirinCognitive DysfunctionFemaleFibrinolytic AgentsHeart Failure, SystolicHumansMaleMiddle AgedRetrospective StudiesStroke VolumeTime FactorsWarfarinAnticoagulantsAspirinFibrinolytic AgentsWarfarincognitive functioncomorbiditiesdementialongitudinal analysisMini-Mental State Examination

Identifiers

PMID31779926
PMCPMC6944056
OpenAlexW2990788841

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.