Naslov
Sex-related differences in left ventricular assist device utilization and outcomes: results from the PCHF-VAD registry
(Sex‐related differences in left ventricular assist device utilization and outcomes: results from the PCHF‐VAD registry)

Autori
Radhoe, Sumant P. ; Jakuš, Nina ; Veenis, Jesse F. ; Timmermans, Philippe ; Pouleur, Anne‐Catherine ; Rubís, Pawel ; Van Craenenbroeck, Emeline M. ; Gaizauskas, Edvinas ; Barge‐Caballero, Eduardo ; Paolillo, Stefania ; Grundmann, Sebastian ; D'Amario, Domenico ; Braun, Oscar Ö. ; Gkouziouta, Aggeliki ; Planinc, Ivo ; Ljubas Maček, Jana ; Meyns, Bart ; Droogne, Walter ; Wierzbicki, Karol ; Holcman, Katarzyna ; Flammer, Andreas J. ; Gašparović, Hrvoje ; Biočina, Bojan ; Miličić, Davor ; Lund, Lars H. ; Ruschitzka, Frank ; Brugts, Jasper J. ; Čikeš, Maja

Vrsta, podvrsta
Radovi u časopisima, znanstveni

Izvornik
ESC heart failure (2022)

Status rada
Online first

Ključne riječi
advanced heart failure ; left ventricular assist device ; utilization ; sex ; survival

Sažetak
Aims Data on sex and left ventricular assist device (LVAD) utilization and outcomes have been conflicting and mostly con- fined to US studies incorporating older devices. This study aimed to investigate sex-related differences in LVAD utilization and outcomes in a contemporary European LVAD cohort. Methods and results This analysis is part of the multicentre PCHF- VAD registry studying continuous-flow LVAD patients. The primary outcome was all-cause mortality. Secondary outcomes included ventricular arrhythmias, right ventricular failure, bleeding, thromboembolism, and the haemocompatibility score. Multivariable Cox regression models were used to assess as- sociations between sex and outcomes. Overall, 457 men (81%) and 105 women (19%) were analysed. At LVAD implant, women were more often in Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) profile 1 or 2 (55% vs. 41%, P = 0.009) and more often required temporary mechanical circulatory support (39% vs. 23%, P = 0.001). Mean age was comparable (52.1 vs. 53.4 years, P = 0.33), and median follow-up duration was 344 [range 147–823] days for women and 435 [range 190–816] days for men (P = 0.40). No significant sex-related differences were found in all-cause mortality (haz- ard ratio [HR] 0.79 for female vs. male sex, 95% confidence interval [CI] [0.50–1.27]). Female LVAD patients had a lower risk of ventricular arrhythmias (HR 0.56, 95% CI [0.33–0.95]) but more often experienced right ventricular failure. No significant sex-related differences were found in other outcomes. Conclusions In this contemporary European cohort of LVAD patients, far fewer women than men underwent LVAD implan- tation despite similar clinical outcomes. This is important as the proportion of female LVAD patients (19%) was lower than the proportion of females with advanced HF as reported in previous studies, suggesting underutilization. Also, female patients were remarkably more often in INTERMACS profile 1 or 2, suggesting later referral for LVAD therapy. Additional research in female patients is warranted.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA