Author + information
- Received February 11, 2013
- Revision received August 30, 2013
- Accepted September 11, 2013
- Published online January 28, 2014.
- Guilherme H. Oliveira, MD∗∗ (, )
- Matthias Dupont, MD†,
- David Naftel, PhD‡,
- Susan L. Myers, BBA‡,
- Ya Yuan, BS‡,
- W.H. Wilson Tang, MD∗,
- Gonzalo Gonzalez-Stawinski, MD§,
- James B. Young, MD∗,
- David O. Taylor, MD∗ and
- Randall C. Starling, MD, MPH∗
- ∗Advanced Heart Failure and Transplantation Center, Division of Cardiovascular Medicine, Harrington Heart and Vascular Institute, University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
- †Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium
- ‡Cardiovascular Surgery Research, University of Alabama at Birmingham, Birmingham, Alabama
- §Department of Cardiothoracic Surgery, Baylor Medical Center, Dallas, Texas
- ↵∗Reprint requests and correspondence:
Dr. Guilherme H. Oliveira, Advanced Heart Failure and Transplantation Center, Division of Cardiovascular Medicine, Harrington Heart and Vascular Institute, University Hospitals Case Medical Center, 11100 Euclid Avenue, LKS 3012, Cleveland, Ohio 44106.
Objectives The aim of this study was to investigate the use of durable mechanical circulatory support (MCS) in patients with chemotherapy-induced cardiomyopathy (CCMP) and determine their outcomes and survival in comparison to that of other patients with end-stage heart failure treated similarly.
Background Patients with end-stage heart failure as a result of CCMP from anthracyclines are often precluded from heart transplantation because of a history of cancer. In such patients, durable MCS may offer an important chance for life prolongation. Yet, there are no data to support the use of MCS in this increasingly prevalent group of patients.
Methods We searched 3,812 MCS patients from June 2006 through March 2011 in the INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) database for the diagnosis of CCMP. We compared characteristics, outcomes, and survival between CCMP patients and patients with nonischemic cardiomyopathy and ischemic cardiomyopathy.
Results Compared with patients with nonischemic cardiomyopathy and ischemic cardiomyopathy, patients with CCMP were overwhelmingly female (72% vs. 24% vs. 13%, p = 0.001), had MCS more often implanted as destination therapy (33% vs. 14% vs. 22%, p = 0.03), required more right ventricular assist device support (19% vs. 11% vs. 6%, p = 0.006), and had a higher risk of bleeding (p = 0001). Survival of CCMP patients was similar to that of other groups.
Conclusions CCMP patients treated with MCS have survival similar to other MCS patients despite more frequent need for right ventricular assist device support and increased bleeding risk.
Ms. Myers is a consultant for HeartWare and Thoratec. Dr. Oliveira is now affiliated with the Advanced Heart Failure and Transplantation Center, Division of Cardiovascular Medicine, Harrington Heart and Vascular Institute University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received February 11, 2013.
- Revision received August 30, 2013.
- Accepted September 11, 2013.
- American College of Cardiology Foundation