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. 2020 Aug;29(8):1226-1233.
doi: 10.1016/j.hlc.2019.11.017. Epub 2019 Dec 13.

Outcomes of Asian-Americans Implanted With Left Ventricular Assist Devices: An Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) Analysis

Iosif Taleb  1 , James Wever-Pinzon  1 , Wenyan Wang  2 , Antigone Koliopoulou  3 , Elizabeth Dranow  3 , Tao Yu  2 , Lixue Yin  2 , Stephen H McKellar  1 , Josef Stehlik  1 , James C Fang  3 , Omar Wever-Pinzon  1 , Craig H Selzman  3 , Stavros G Drakos  4
Affiliations

Outcomes of Asian-Americans Implanted With Left Ventricular Assist Devices: An Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) Analysis

Iosif Taleb et al. Heart Lung Circ. 2020 Aug.

Abstract

Background: Studies have indicated differences between Asians and Whites in their propensity for stroke, coronary artery disease, heart failure, bleeding and thrombosis. We investigated whether Asian-Americans on durable left ventricular assist devices (LVADs) exhibit differential morbidity and mortality when compared to Whites.

Methods: We analysed prospectively collected data from the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) database to compare the outcomes after LVAD implantation of Asians versus Whites.

Results: In total, 7,018 patients were included, 130 were identified as Asian-Americans. Asian-Americans were younger, had lower body mass index, higher serum bilirubin and lower albumin levels. In a multivariable regression model, there was no difference in survival between the two groups. Asian-Americans had lower incidence of device malfunction and after adjusting for multiple factors this remained lower. The adjusted risk of a major safety composite outcome, including major bleeding, major infection, stroke and device malfunction, revealed no difference between the two groups.

Conclusions: Although prior studies have reported worse cardiac surgery outcomes in Asians, in this INTERMACS analysis Asian-Americans appear to have similar survival and risk of adverse events as their White counterparts. The incidence of device malfunction was lower in the Asian-Americans, both in a univariate model and after adjusting for multiple clinical factors. Future, larger studies of Asian-Americans with end-stage heart failure and LVAD support are warranted to confirm these results.

Keywords: Asians; Interagency registry for mechanically assisted circulatory support (INTERMACS); Left ventricular assist devices (LVADs); Outcomes.

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Conflict of interest statement

Conflict of Interest Dr Stavros Drakos serves as consultant for Abbott Laboratories. None of the other authors has anything to disclose.

Figures

Figure 1.
Figure 1.
Kaplan-Meier multivariate time to mortality curve for Asian-Americans versus Whites.
Figure 2.
Figure 2.
Kaplan Meier multivariate time to left ventricular assist device (LVAD) malfunction curve for Asian-Americans versus Whites. P-values for the log-rank test are also shown in these figures.
Figure 3.
Figure 3.
Kaplan-Meier survival curve of composite 1 event, for Asian-Americans versus Whites.
Figure 4.
Figure 4.
Kaplan-Meier survival curve of composite 2 event, for Asian-Americans versus Whites.
See this image and copyright information in PMC

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