Low blood pressure, low serum cholesterol and anemia predict early necessity of ventricular assist device implantation in patients with advanced heart failure at the time of referral from non-ventricular assist device institutes.

Abstract

BACKGROUND:

The timing of ventricular assist device (VAD) implantation is always a matter of debate, especially when a patient is referred from a non-VAD institute. We focused on objective noninvasive parameters at the time of admission to a VAD implant center and analyzed the factors predicting the necessity of early VAD. METHODS AND RESULTS: We retrospectively analyzed advanced heart failure (HF) patients referred since January 2011, including patients less than 65 years old. They all had a history of hospitalization for HF management in non-VAD institutes within 1 month before referral. We excluded patients transferred with mechanical circulatory support. We enrolled 46 patients (40 males, 39.8±13.4 years old). Among them, 26 patients had a VAD implanted or died within 120 days. By multivariable logistic analysis using admission parameters, systolic blood pressure (BP) <93 mmHg [odds ratio (OR) 13.335], hemoglobin <12.7 g/dl (OR 12.175) and serum total cholesterol <144 mg/dl (OR 8.096) were significant predictors of early VAD requirement. We constructed a scoring system according to the ORs, and the area under the receiver-operating characteristic curve was 0.913.

CONCLUSIONS:

Low BP, low serum cholesterol and anemia on admission predict early VAD in advanced HF patients who have been treated in non-VAD institutes. Such patients should be promptly referred to a VAD implant center.

• Authors: Takeo Fujino, Koichiro Kinugawa, Masaru Hatano, Teruhiko Imamura, Hironori Muraoka, Shun Minatsuki, Toshiro Inaba, Hisataka Maki, Osamu Kinoshita, Kan Nawata, Atsushi Yao, Minoru Ono, Issei Komuro
• Journal: Circulation journal : official journal of the Japanese Circulation Society (Circ J) Vol. 78 Issue 12 Pg. 2882-9 ( 2014) ISSN: 1347-4820 [Electronic] Japan
• PMID: 25421232 (Publication Type: Journal Article)

Chemical References

• Cardiovascular Agents
• Cholesterol

Topics

• Adult
• Anemia (epidemiology)
• Anthropometry
• Area Under Curve
• Cardiovascular Agents (therapeutic use)
• Cholesterol (blood)
• Combined Modality Therapy
• Comorbidity
• Female
• Heart Failure (blood, mortality, physiopathology, therapy)
• Heart-Assist Devices (supply & distribution)
• Humans
• Hypotension (epidemiology)
• Japan
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Patient Selection
• ROC Curve
• Referral and Consultation
• Retrospective Studies
• Risk Assessment
• Severity of Illness Index
• Time Factors