Author + information
- Geetha Bhat,
- Ashim Aggarwal,
- Antone Tatooles,
- Mark Slaughter,
- Ulrich Jorde,
- Robert Brewer,
- Leway Chen,
- Kartik Sundareswaran and
- David Farrar
This study examines racial disparities in advanced heart failure patients treated with left ventricular assist devices (LVAD). We hypothesize that specialized treatment in a comprehensive heart failure/assist device program results in similar survival amongst various ethnicities.
A retrospective analysis of HeartMate II clinical trial database was performed. Patients were categorized as Caucasians (Cau), African Americans (AA) and Others (Hispanics, Asians, ethnic minorities). Variables analyzed included demographics, 2-year survival and right heart failure and HeartMate II risk score (age, albumin, creatinine, INR).
637 of the 1126 patients (53.6%) received LVAD as Destination Therapy. The HeartMate II risk score was significantly higher compared to other groups (p=0.004). No difference was seen in baseline renal or hepatic profiles. Survival by Kaplan-Meier analysis revealed a higher unadjusted survival (P<0.001) for the Others compared to AA and Cau.
This survival advantage was lost after adjustment for female gender, ischemic etiology and HeartMate II risk score. There was no difference in survival between the AA and Cau either (p=0.25).
|Race||Age (Years)||Female Sex (N,%)||LVEF(%)||Ischemic Etiology||Right Heart Failure (events/patient year)||HeartMate II Risk Score||2-year survival (%)|
|Caucasian (N=830)||61.0±12.3||150 (18%)||17.0 ± 6.1||517 (62%)||200 (0.15)||1.85±1.28||58±2.0%|
|African American (N=215)||49.8±14.7||83 (39%)||15.3 ± 5.7||44 (20%)||58 (0.14)||1.65±0.98||67±3.8%|
|Others (N=81)||56.3±15.9||17 (21%)||17.9 ± 5.7||38 (47%)||21 (0.13)||1.64±0.93||77±5.3%|
|P value||<0.001||<0.001||<0.001||<0.001||0.73||0.004||p< 0.001 (unadjusted)|
In patients with advanced heart failure, no difference in survival exists based on ethnicity. This is probably reflective of standardized medical care in treating all patient cohorts.
Moderated Poster Contributions
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Heart Failure: Mechanical Circulatory Support
Abstract Category: 17. Heart Failure: Therapy
Presentation Number: 1260M-269
- 2013 American College of Cardiology Foundation