Author + information
- Rahat Muslema,b,
- Kadir Caliskana,b,
- Sakir Akina,b,
- Emre Y. Yasara,b,
- Ad J.J.C. Bogersa,b,
- Dennis A. Hesselinka,b,
- Glen J.R. Withmana,b,
- Ryan Tedforda,b,
- Olivier Manintvelda,b and
- Stuart Russella,b
Background: Left ventricular assist devices (LVAD) are increasingly used, especially as destination therapy in elderly. The aim of this study was to evaluate the effect of age on renal function and mortality in the first year after implantation.
Methods: A retrospective multicenter cohort study was conducted, evaluating all LVAD patients implanted in the two participating centers (age ≥18 years and minimal survival >48 hrs). Patients were stratified according the age groups <45, 45-54, 55-54, and ≥65 years old.
Results: Overall, 241 patients were included (mean age 52.4 ± 12.9 years, 76% males, 33% destination therapy). The mean eGFR at one year was 85, 72, 69, and 49 mL/min per 1.73 m2 in the age groups <45, 45-54, 55-54, and ≥65 (p < 0.001) respectively. Ages 55-65 (p=0.04) and ages ≥65 (p<0.001) were independent predictors of worsening renal function (eGFR) at one year. The one-year survival post-implantation was 79%,84%, 68%, and 54% for those in the age group <45, 45-54, 55-64 and ≥65 (Log-rank p=0.003). Age ≥65 (p=0.02) was an independent predictor of one-year mortality. When stratified by age <60 and ≥60 years and sub-classified in to eGFR classes, the one-year survival was 86%, 73%, 67%, 69%, 56% and 43% (Log-rank p=0.035, figure 1), respectively.
Conclusions: Older age adversely affects renal function and survival one-year post-implantation. Older age combined with reduced renal function had a cumulative adverse effect on survival and is important to consider when selecting patients for LVAD implantation.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: The Evolving World of LVADs, Transplant and Other Novel Discoveries
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1294-292
- 2017 American College of Cardiology Foundation