Journal article
Defining Optimal Outcomes in Patients with Left Ventricular Assist Devices
ASAIO journal (1992), v 67(4), pp 397-404
01 Apr 2021
PMID: 32701625
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Left ventricular assist devices (LVADs) have consistently and successfully improved mortality associated with end-stage heart failure. However, the definition of an "optimal" outcome post LVAD as a benchmark remains debatable. We retrospectively examined patients in the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) between 2012 and 2016 to assess 1 year post-LVAD "optimal outcome" defined as a patient who was alive on device or transplanted, New York Heart Association functional class I/II, had no more than 2 hospitalizations at year 1, and no major adverse event. We identified the features predicting a nonoptimal outcome at 1 year. Finally, we focused on 3 years outcomes in patients implanted as destination therapy. Of the 12,566 patients in INTERMACS who received an LVAD, only 3,495 (27.8%) met our definition of optimal LVAD outcome at 1 year. These patients tended to be younger, male, and were four times more likely to be supported as bridge to transplantation. For those with optimal outcome at year 1, their chances of long-term survival were better than those who were alive at year 1, but did not meet criteria for an optimal outcome. In the destination therapy population, only 14% of patients met the definition of an optimal outcome at 3 years. Despite significantly improved survival in patients with end-stage heart failure treated with LVAD therapy, majority patients had nonoptimal outcomes at 1 and 3 years post implant, by our definition. There is a pressing need to create a benchmark to define optimal outcomes post LVAD, both in our clinical trials and practice.
Metrics
Details
- Title
- Defining Optimal Outcomes in Patients with Left Ventricular Assist Devices
- Creators
- Manreet K. Kanwar - Allegheny General HospitalColleen K. McIlvennan - University of Colorado Anschutz Medical CampusLisa C. Lohmueller - Carnegie Mellon UniversityStephen H. Bailey - Allegheny General HospitalJoseph G. Rogers - Duke Medical CenterJeffrey Teuteberg - Stanford UniversityJennifer Cowger - Henry Ford Hospital
- Publication Details
- ASAIO journal (1992), v 67(4), pp 397-404
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 8
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Cardiothoracic Surgery; Cardiology
- Web of Science ID
- WOS:000639298100011
- Scopus ID
- 2-s2.0-85100182751
- Other Identifier
- 991021932188704721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Engineering, Biomedical
- Transplantation