Cognitive impairment was highly prevalent in our cohort, and several independent clinical predictors were identified, including diabetes mellitus, history of stroke or transient ischemic attack (TIA), carotid artery disease, elevated NT-proBNP levels, lower estimated glomerular filtration rate (eGFR), and reduced health-related quality of life assessed by the Kansas City Cardiomyopathy Questionnaire (KCCQ). Here, NPPB is linked to diabetes mellitus.