Prognostic Implications of Changes in Albumin Following Left Ventricular Assist Device Implantation in Patients With Severe Heart Failure

Gopal, Dipika; Hanff, Thomas C.; Mazurek, Jeremy A.; Grandin, Wilson; Howard, Jessica; Forde-McLean, Rhondalyn; Wald, Joyce; King, Kathie; Acker, Michael A.; Goldberg, Lee R.; Jessup, Mariell; Atluri, Pavan; Margulies, Kenneth B.; Rame, J. Eduardo; Birati, Edo Y.

doi:10.1016/j.amjcard.2017.08.005

Cited by 10 publications

(4 citation statements)

References 29 publications

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“…The BTB strategy was independently associated with increased risk of death in addition to other conventional risk factors including age, smaller body size, hypoalbuminemia, and renal impairment. [11][12][13] The predominant causes of death were stroke and infection in both cohorts. As reported previously, the incidence of pump infection, probably due to more complex and longer surgery, would be higher in the BTB cohort than in the primary implant cohort, given the presence of pre-implanted surgical temporary MCS.…”

Section: Survival Comparisonmentioning

confidence: 97%

Bridge-to-Bridge Left Ventricular Assist Device Implantation Strategy vs. Primary Left Ventricular Assist Device Implantation Strategy

Imamura

Kinugawa

Ōno

et al. 2020

Circ J

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those with INTERMACS profile 1, 4 the paracorporeal pulsatile LVAD implantation (Nipro VAD or AB5000), a counterpart of the Thoratec PVAD (Thoratec, Pleasanton, CA, USA), has long been used as a strategy for bridge-todecision or -candidacy, followed by conversion to durable LVAD as a bridge-to-transplantation (i.e., secondary device) if applicable. Recently, an extracorporeal continuousflow centrifugal pump (RotaFlow, Gyro pump, or Mera pump), which is a counterpart of CentriMag (Levitronix LLC, Waltham, MA, USA), has replaced almost all paracorporeal pulsatile LVADs, because of having fewer adverse events. In addition, central extracorporeal membranous G iven the improvement of mechanical assist device technology and increasingly sophisticated perioperative management, the mortality and morbidity following durable left ventricular assist device (LVAD) implantation have greatly improved, particularly among those with stable preoperative hemodynamics dependent on continuous inotropes who typically are classified as INTERMACS profile 3. 1,2 However, optimal therapeutic strategies for those with clinical deterioration assigned to INTERMACS profile 1 remain controversial. 3 Based on the guidelines from Japanese academic societies, which do not recommend durable LVAD implantation for

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Section: Survival Comparisonmentioning

confidence: 97%

Bridge-to-Bridge Left Ventricular Assist Device Implantation Strategy vs. Primary Left Ventricular Assist Device Implantation Strategy

Imamura

Kinugawa

Ōno

et al. 2020

Circ J

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“…Previous studies in patients with CHF or those referred for LV assist device showed improved outcomes with increase and correction of serum albumin levels [38,39]. Furthermore, infusion of albumin in critically ill patients with serum albumin levels of 3 g/dL or below was shown to be beneficial [40].…”

Section: Serum Albumin As a Potential Target For Interventionmentioning

confidence: 96%

Changes over time in serum albumin levels predict outcomes following percutaneous coronary intervention

Shiyovich

Bental

Assali

et al. 2020

Journal of Cardiology

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Background: Serum albumin (SA) is a powerful prognostic marker in patients with cardiovascular diseases. Objectives: To evaluate the prognostic significance of changes in SA levels among patients that underwent percutaneous coronary intervention (PCI). Methods: Patients who underwent PCI in a tertiary medical center throughout 2004-2017 were considered for the study. Patients with missing SA values within the year before or 5 years after the PCI were excluded from the study as well as those for whom SA values were obtained throughout an acute infection. Changes in albumin were represented by Dalbumin: Albumin before PCI (closest) minus lowest albumin within the 5 years following the PCI. Dalbumin was categorized into 4 categories as follows: 0 g/dL, 0-0.5 g/dL, 0.5-1 g/dL, !1 g/dL. Primary outcome was major adverse cardiac events (MACE) that included all-cause mortality, non-fatal myocardial infarction, target vessel re-vascularization, and coronary artery bypass surgery. Results: The study included 5449 out of 21,763 (25%) patients, mean age 66.8 AE 12 years, 26% women.Patients with greater Dalbumin were older with higher prevalence of most cardiovascular risk factors and comorbidity. The follow-up period was 7 years (median), with cumulative MACE rate of 49.5%. MACE rates and the rates of all the MACE components increased gradually with the increase in Dalbumin. Multivariate adjusted analysis showed that Dalbumin is an independent predictor of long-term MACE following PCI [HR = 1.4 (95%CI:1.3-1.6), HR = 2.2 (95%CI:1.9-2.5), HR = 3.8 (95%CI:3.3-4.35) for Dalbumin of 0-0.5 g/dL, 0.5-1 g/dL, !1 g/dL, respectivelyp < 0.001 for all]. Conclusions: A decrease in albumin levels following PCI is an independent prognostic marker of worse long-term outcomes.

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“…Several authors investigated the clinical implications of "change" in serum albumin levels following LVAD implantation. 14,15 Among them, an increase in serum albumin level was associated with fewer adverse events. However, a "change" in serum albumin levels would depend on its baseline.…”

Section: Changes In Serum Albumin Level Following Lvad Implantationmentioning

confidence: 99%

Perioperative improvement in serum albumin level in patients with left ventricular assist device

Imamura

Combs

Siddiqi

et al. 2020

Journal of Cardiac Surgery

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Background: The negative impact of baseline hypoalbuminemia on clinical outcome following left ventricular assist device (LVAD) implantation is well known. However, the implications of perioperative change in serum albumin levels on post-LVAD outcomes remain uninvestigated. Methods: Among consecutive patients with baseline serum albumin <3.5 g/dl who received durable LVAD implantation between April 2014 and August 2017 and were followed for 1 year, the impact of perioperative change in serum albumin level from baseline to 3 months post-LVAD on the incidence of adverse events was investigated. Results: Sixty-eight patients (median 60 years and 69% male) were included. Serum albumin change was an independent predictor of the occurrence of adverse events with an adjusted hazard ratio of 0.32 (95% confidence interval, 0.13-0.78) and a cutoff change of 0.7 g/dl. Those with albumin increase >0.7 g/dl had higher 1-year freedom from adverse events (45% vs. 14%, p = .008), dominantly due to lower incidence of death or sepsis compared with those without (p < .05 for both). Conclusion: Among those with baseline hypoalbuminemia, a considerable perioperative increase in serum albumin levels following LVAD implantation was associated with lower mortality and morbidity. The implication of aggressive nutrition intervention on LVAD patients is the next concern.

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Prognostic Implications of Changes in Albumin Following Left Ventricular Assist Device Implantation in Patients With Severe Heart Failure

Cited by 10 publications

References 29 publications

Bridge-to-Bridge Left Ventricular Assist Device Implantation Strategy vs. Primary Left Ventricular Assist Device Implantation Strategy

Bridge-to-Bridge Left Ventricular Assist Device Implantation Strategy vs. Primary Left Ventricular Assist Device Implantation Strategy

Changes over time in serum albumin levels predict outcomes following percutaneous coronary intervention

Perioperative improvement in serum albumin level in patients with left ventricular assist device

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