Author + information
- Selim Krim,
- Rey Vivo,
- Andrea Cordero-Reyes,
- Matthias Loebe,
- Brian Bruckner,
- Guillermo Torre-Amione,
- Arvind Bhimaraj,
- Hector Ventura and
- Jerry Estep
Right ventricular failure (RVF) remains an important cause of mortality in patients with continuous-flow left ventricular assist devices (LVAD). We aimed to assess the predictive value of total bilirubin/albumin (Bili/Alb) ratio, markers of congestion and malnutrition/inflammation, for RVF post-LVAD implantation.
We reviewed the patient characteristics, laboratory values and hemodynamic data of our prospectively collected database of 109 patients who were implanted with a continuous-flow LVAD from January 2004 through July 2011 in a single center. RVF was defined as requirement of a right ventricular assist device or >14 consecutive days of inotropic support.
Overall, 12 (11%) patients developed RVF post-LVAD. An increased Bili/Alb ratio was significantly associated with RVF (odds ratio 3.08, 95% confidence interval 1.47 to 6.44, p = 0.003). Scatterplot analysis with regression determined the optimal cutoff value for the ratio as 0.53. Receiver operating curve analysis determined an area under the curve (AUC) of 0.70 (Figure). Moreover, the addition of this novel parameter further improved the predictive value of an established RVF risk score (Kormos score: AUC=0.63; composite Kormos+Bili/Alb ratio: AUC=0.69).
An increased Bili/Alb ratio ≥0.53 is associated with a higher risk for RVF in patients supported with continuous-flow LVAD. This practical and novel parameter improves the RVF predictive value of an established clinical risk model.
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: New Paradigms in Prognostic Role of Biomarkers in Heart Failure
Abstract Category: 15. Heart Failure: Clinical
Presentation Number: 1265-308
- 2013 American College of Cardiology Foundation