Left Ventricular Assist Device Therapy and Acute Pancreatitis: Higher Incidence and Worse Clinical Outcomes

Juan E. Corral, Paul T. Kröner, Bhavya Yarlagadda, Lalitha P.R. Vemireddy, Karn Wijarnpreecha, Rohan M. Goswami, Massimo Raimondo, Yan Bi

Research output: Contribution to journalArticlepeer-review

Abstract

Objective The aim of the study was to compare incidence and outcomes of acute pancreatitis among advanced heart failure therapies. Methods Two retrospective cohorts are as follows: A, patients with heart failure presenting to our hospitals and B, the US National Inpatient Sample. Three groups were compared: left ventricular assist device (LVAD) recipients, transplant recipients, and controls who did not qualify for advanced therapies. Primary outcomes were pancreatitis incidence and mortality. Secondary outcomes included kidney failure, multiorgan failure, shock, and health care utilization. Results Cohort A included 1344 heart failure patients, and cohort B included 677,905 patients with acute pancreatitis. In cohort A, annual pancreatitis incidence was 6.7 cases per 1000 LVAD recipients, 4.1 per 1000 LVAD bridge-to-transplant, 2.3 per 1000 transplant recipients, and 3.2 per 1000 heart failure controls (P = 0.03). Combined, the incidence was 5.6 per 1000 LVAD users and 2.7 in 1000 non-LVAD users (relative risk, 2.1; P = 0.009). In cohort B, increased mortality was seen in LVAD users, but not in transplant recipients. Left ventricular assist device patients had higher odds of kidney failure, multiorgan failure, shock, and intensive care. Conclusions Patients with LVAD have double risk of pancreatitis, worse clinical outcomes, and increased healthcare utilization. Studies elucidating the mechanisms behind pancreatic injury in advanced heart failure are suggested.

Original languageEnglish (US)
Pages (from-to)1069-1074
Number of pages6
JournalPancreas
Volume49
Issue number8
DOIs
StatePublished - Sep 1 2020

Keywords

  • AICD - automated implantable cardioverter defibrillator
  • AKI - acute kidney injury
  • EF - ejection fraction
  • HCUP - Healthcare Cost and Utilization Project
  • HFpEF - heart failure with preserved ejection fraction
  • HFrEF - heart failure with reduced ejection fraction
  • HR - hazard ratios
  • ICD - International Classification of Diseases
  • Key Words/Abbreviations
  • LVAD - left ventricular assist device
  • NIS - National Inpatient Sample
  • OR - odds ratio
  • acute pancreatitis
  • heart failure
  • heart transplantation
  • left ventricular assist device

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Endocrinology

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