A multi-institutional outcome analysis of patients undergoing left ventricular assist device implantation stratified by sex and race

Justin van Meeteren, Simon Maltais, Shannon M. Dunlay, Nicholas A. Haglund, Mary Beth Davis, Jennifer Cowger, Palak Shah, Keith D. Aaronson, Francis D. Pagani, John M. Stulak

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

Background Earlier studies have demonstrated disparities in patients undergoing left ventricular assist device (LVAD) implantation when stratified according to sex and race. Because very few data exist from large investigations, we reviewed data from the registry of the Mechanical Circulatory Support Research Network. Methods Between May 2004 and September 2014, 734 patients underwent primary LVAD implantation at our institutions. Median age at implant was 57 (range 18 to 82) years and there were 577 males (80%). Race included Caucasian (C) in 586 patients (82%), African-American (AA) in 112 (16%), and other (O) in 21 (3%). Between sexes, significant pre-operative differences most commonly included median age at implant (males 60 years, females 57 years), ischemic etiology (53% vs 35%) and mean INTERMACS profile (2.9 vs 2.5). Between races, significant pre-operative differences most commonly included median age at implant (C = 61 vs AA = 51 vs O = 51), New York Heart Association functional class (85% vs 100% vs 92%) and ischemic etiology (55% vs 24% vs 40%). Results There were no significant differences in survival at 1, 3 or 5 years by sex or race. Similarly, there were no differences in time-related freedom from stroke, drive-line infection, gastrointestinal bleeding or pump thrombus by sex or race. After controlling for differences, neither sex nor race was associated with survival (p = 0.09 and p = 0.18, respectively), stroke (p = 0.28 and p = 0.21), drive-line infection (p = 0.9 and p = 0.92), gastrointestinal bleed (p = 0.48 and p = 0.45) or pump thrombus (p = 0.99 and p = 0.8). Conclusions In this large, multi-institutional analysis, although some pre-operative clinical characteristics varied, they did not translate into any significant differences in late survival or complications while on LVAD support.

Original languageEnglish (US)
Pages (from-to)64-70
Number of pages7
JournalJournal of Heart and Lung Transplantation
Volume36
Issue number1
DOIs
StatePublished - Jan 1 2017

Keywords

  • disparities
  • mechanical circulatory assistance
  • race
  • ventricular assist device
  • ventricular assist device

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine
  • Transplantation

Fingerprint Dive into the research topics of 'A multi-institutional outcome analysis of patients undergoing left ventricular assist device implantation stratified by sex and race'. Together they form a unique fingerprint.

  • Cite this