Outcomes of LVAD Insertion in Ischemic vs Non-Ischemic Cardiomyopathy Patients

Kumar, Sanjay; Ward, Charisse; Taghavi, Sharven; Wilson, Lynn; Mangi, Abeel A.

doi:10.1016/j.cardfail.2012.06.152

Cited by 2 publications

(6 citation statements)

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“…In a study among 100 patients with ICM or NICM, mortality rates following device implantation were not significantly different between the 2 groups. 12 In contrast, Kumar and colleagues 17 reported that ICM was an independent predictor of death after LVAD implantation. The matter is further complicated by limited duration of follow-up and small samples, which makes it difficult to determine whether the cause of ESHF has a significant impact on patient outcomes following LVAD therapy over a longer period.…”

Section: Discussionmentioning

confidence: 95%

“…Characteristics of the included studies are provided in Table 1 . Five studies were conducted at centres in the United States, 11 , 12 , 17 – 19 and 2 were conducted at Japanese centres. 20 , 21 Six studies were single-centre observational studies or case series, and 1 study was a multicentre study that examined patient records from 31 centres in the US.…”

Section: Resultsmentioning

confidence: 99%

“… 11 The HeartMate II (Thoratec Corporation) was the most commonly used device (96.4%), with the HeartWare (HeartWare International) (2.4%) and Jarvik 2000 (Jarvik Heart) (1.2%) being more rarely used. 11 , 12 , 17 – 21 …”

Section: Resultsmentioning

confidence: 99%

“…Study quality as assessed with the Newcastle–Ottawa Quality Assessment Scale for Cohort Studies is shown in Table 4 . Although we included the result from Kumar and colleagues 17 in our review, it was not possible to complete proper quality assessment on this study because only the abstract was available to us. We therefore excluded this study from the meta-analysis since we could not be confident in its quality.…”

Section: Resultsmentioning

confidence: 99%

“…2B ) (OR 1.00, 95% CI 0.47–2.12) after LVAD implantation. Interestingly, Kumar and colleagues 17 observed a trend toward increased survival in patients with NICM at both 30 days and 1 year after device implantation, and Tsiouris and colleagues 12 observed a trend toward increased survival in patients with NICM at 1 year. However, John and colleagues 11 observed slightly increased survival in patients with ICM at both 30 days and 1 year after implantation.…”

Section: Resultsmentioning

confidence: 99%

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Clinical effectiveness of therapy with continuous-flow left ventricular assist devices in nonischemic versus ischemic cardiomyopathy: a systematic review and meta-analysis

Wavell

Sokolowski

Klingel

et al. 2021

cjs

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Background: Clinicians may be less inclined to consider long-term left ventricular assist device (LVAD) therapy in end-stage heart failure (ESHF) as a result of nonischemic cardiomyopathy (NICM) versus ischemic cardiomyopathy (ICM) owing to potentially greater right ventricular involvement in the former; however, it is unknown whether the cause of heart failure has a clinically meaningful effect on outcomes following LVAD implantation. In this systematic review, we aimed to determine whether ischemic versus nonischemic etiology has any impact on patient-relevant outcomes. Methods: We searched MEDLINE, Embase, PubMed and the Cochrane Library for studies published in English between Jan. 1, 2000, and Nov. 22, 2018, that examined survival and transplantation rates following LVAD implantation in patients with NICM or ICM. Randomized clinical trials, cohort studies, case–control studies, cross-sectional studies and case series with a sample size of at least 8 patients were eligible for inclusion. To be included in the meta-analysis, outcomes had to include at least death reported at 30 days or 1 year after LVAD implantation. Quality of included studies was assessed by 2 independent reviewers using the Newcastle–Ottawa Quality Assessment Scale for Cohort Studies. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) quality-assessment tool was used to assess outcomes (30-d survival, 1-yr survival and cardiac transplantation following LVAD therapy) across studies. Results: From a total of 2843 citations identified, 7 studies met all inclusion criteria. Studies were generally of good quality, but reporting of patient demographic characteristics, outcomes and complications was heterogeneous. We found no significant difference in 30-day or 1-year survival or in cardiac transplantation rates after device implantation between the NICM and ICM groups. Patients in the 2 groups had similar outcomes up to 1 year with LVAD therapy. Conclusion: Early outcomes of LVAD therapy do not appear to be affected by heart failure etiology. Ongoing investigation is required to determine the long-term outcomes of LVAD therapy in ICM and NICM. Systematic review registration: PROSPERO register, record ID 76483

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Section: Discussionmentioning

confidence: 95%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Clinical effectiveness of therapy with continuous-flow left ventricular assist devices in nonischemic versus ischemic cardiomyopathy: a systematic review and meta-analysis

Wavell

Sokolowski

Klingel

et al. 2021

cjs

View full text Add to dashboard Cite

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Continuous-Flow Left Ventricular Assist Device Support in Patients with Ischemic Versus Nonischemic Cardiomyopathy

Chou

Critsinelis

Lamba

et al. 2021

Texas Heart Institute Journal

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To determine whether the cause of cardiomyopathy affects outcomes in patients who undergo continuous-flow left ventricular assist device support, we compared postimplant adverse events and survival between patients with ischemic and nonischemic cardiomyopathy. The inclusion criteria for the ischemic group were a history of myocardial infarction or revascularization (coronary artery bypass grafting or percutaneous coronary intervention), ≥75% stenosis of the left main or proximal left anterior descending coronary artery, or ≥75% stenosis of ≥2 epicardial vessels. From November 2003 through March 2016, 526 patients underwent device support: 256 (48.7%) in the ischemic group and 270 (51.3%) in the nonischemic group. The ischemic group was older (60.0 vs 50.0 yr), included more men than women (84.0% vs 72.6%), and had more comorbidities. More patients in the nonischemic group were able to have their devices explanted after left ventricular recovery (5.9% vs 2.0%; P=0.02). More patients in the ischemic group had gastrointestinal bleeding (31.2% vs 22.6%; P=0.03), particularly from arteriovenous malformations (20.7% vs 11.9%; P=0.006) and ulcers (16.4% vs 9.3%; P=0.01). Kaplan-Meier analysis revealed no difference in overall survival between groups (P=0.24). Older age, previous sternotomy, higher total bilirubin level, and concomitant procedures during device implantation independently predicted death (P ≤0.03), whereas cause of heart failure did not (P=0.08). Despite the similarity in overall survival between groups, ischemic cardiomyopathy was associated with more frequent gastrointestinal bleeding. This information may help guide the care of patients with ischemic cardiomyopathy who receive continuous-flow left ventricular assist device support.

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Outcomes of LVAD Insertion in Ischemic vs Non-Ischemic Cardiomyopathy Patients

Cited by 2 publications

References 0 publications

Clinical effectiveness of therapy with continuous-flow left ventricular assist devices in nonischemic versus ischemic cardiomyopathy: a systematic review and meta-analysis

Clinical effectiveness of therapy with continuous-flow left ventricular assist devices in nonischemic versus ischemic cardiomyopathy: a systematic review and meta-analysis

Continuous-Flow Left Ventricular Assist Device Support in Patients with Ischemic Versus Nonischemic Cardiomyopathy

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